三维超声心动图评价心肌梗死患者左室局部心功能

目的　本研究采用动态三维超声心动图技术对心肌梗死患者左心室节段心功能进行初步研究。方法　研究对象83例(包括正常人4 1例,心肌梗死患者4 2例) ,采用Agilent Sonos 5 5 0 0型彩色多普勒超声心动图仪进行二维图像采集,采用德国Tom Tec公司的Gmb H型三维图像处理系统进行三维图像分析。结果　绝大多数节段心肌梗死组局部舒张末容量和局部收缩末容量明显大于正常对照组相应节段( P均<0 .0 5 ) ,心肌梗死组前间隔基底部、前间隔中间部和室间隔心尖部这3个部位局部心搏量和局部射血分数显著低于正常对照组( P均<0 .0 5 ) ,心肌梗死组部分节段(侧壁基底部、后壁基底部、下壁基底部、室间隔基底部、侧壁中间部、后壁中间部、下壁中间部和室间隔中间部)局部-整体射血分数显著低于对照组相应节段( P<0 .0 5 )。结论　心肌梗死部位相应节段局部心功能显著下降,而未梗死部位相应节段局部心功能代偿性增强,局部射血分数是反映左室局部心功能的较好指标

3-D Echocardiographic Evaluation of LV Regional Function in Patients with Myocardial Infarction

Objective To study the differences of three-dimensional systolic regional function parameters between MI segments and non-MI segments.Methods The study population consisted of 41 normal objects and 42 patients with coronary heart disease.Three-dimensional analysis was performed using Gmb H three-dimensional imaging system (TomTec,Gemany),equipped with 4D-LV analysis (Ver.1.0 software)which can reconstruct the endocardial contour by surface extract method and can divide the whole left ventricle into 16 segments according to recommendations of ASE.The volumes of each segment was calculated automatically.Results The regional end-diastolic and end-systolic volume of most segments in the MI group were significantly higher than those in the control group (P<0.05).The regional stroke volume of some segments (basal anteroseptal wall,medium anteroseptal wall,and apical septal wall) in the MI group were significantly lower than those in the control group( P<0.05 for all),while the regional stroke volumes were higher in non-MI walls (lateral and posterior wall) than those of the control group.The regional ejection fraction of most segments (except medium lateral wall) in the MI group was significantly lower than those in the control.The regional to global EF ratioes(EFRGs) of some segments (basal anteroseptal wall,medium anteroseptal wall,apical anterior wall and apical septum) were significantly lower in the MI group than those in the control group (P<0.05 for all),while the EFRGs of the non-MI segments (basal lateral wall,basal posterior wall,medium lateral wall and medium posterior wall) were higher in the MI group than those in the control.Conclusions The regional cardiac function of MI segments was decreased significantly,and the regional function of non-MI segments was increased compensatively.