实时三维超声心动图评价心肌梗死合并室壁瘤患者左心室容积及射血分数

目的:探讨实时三维超声心动图(RT-3DE)定量评价心肌梗死合并室壁瘤患者左心室容积及射血分数的可行性及准确性.方法:应用RT-3DE、常规超声心动图双平面Simpson's法和M型超声心动图Teichholz法测量23例心肌梗死合并室壁瘤患者左心室舒张末期容积(LVEDV)、收缩末期容积(LVESV)、每搏量(SV)及射血分数(EF),以左心室造影为参考标准.结果:RT-3DE测量所得LVEDV、LVESV、SV、EF与左心室造影结果具有良好的相关性,r分别为0.92、0.90、0.88、0.91(P均＜0.001),LVEDV、LVESV、SV、EF测值均较左心室造影略小,但两者无显著性差异.二维超声心动图的双平面Simpson's法与左心室造影具有良好的相关性,r分别为0.85、0.87、0.86、0.91(P均＜0.001),LVEDV、LVESV、SV、EF测值均较左心室造影小,双平面Simpson's法与左心室造影测得的LVEDV、LVESV之间有显著差异(P＜0.05),但两者的SV、EF之间无差异;M型超声心动图Teichholz法与左心室造影结果具有一定的相关性,r分别为0.73、0.71、0.70、0.65(P均＜0.05),LvEDV、LVESV、SV、EF测值均较左心室造影大(P＜0.05或P＜0.01).结论:RT-3DE较常规超声心动图能更准确地评价心肌梗死伴室壁瘤患者左心室容积及EF.

Real-time three dimensional echocardiography in evaluation of left ventricular volume and ejection fraction in patients with aneurysm combined with myocardial infarction

Objective:To assess the feasibility and accuracy of real-time three dimensional echocardiography(RT-3DE) in quantitative evaluation of left ventricular(LV) volume and ejection fraction(EF) in patients with ventricular aneurysm and myocardial infarction.Methods: Twenty-three patients with left ventricular aneurysm combined with myocardial infarction were examined by RT-3DE,two dimensional echocardiography Simpson's method,and M-mode Teichholz method separately.The following parameters: left ventricular end diastolic volume(LVEDV),end systolic volume(ESV),stroke volume(SV) and EF were obtained by each method and the results were compared with those obtained by left ventriculography(LVG).Results: The values of LVEDV,LVESV,SV,and EF determined by RT-3DE showed good correlations with those determined by LVG(r=0.92,0.90,0.88,and 0.91,respectively;P<0.001),with the values by RT-3DE slightly smaller than those by LVG(P>(0.05).) The values of LVEDV,LVESV,SV,and EF determined by Simpson's method also showed good correlations with those determined by LVG(r=0.85,0.87,0.86,0.91,respectively;P<0.001),with the values by Simpson's method smaller than those by LVG(P<0.05 for LVEDV and LVESV).The values of LVEDV,LVESV,SV,and EF determined by M-mode Teichholz method also showed good correlations with those determined by LVG(r=0.73,0.71,0.70,0.65,respectively;P<0.05),with the values by M-mode Teichholz method larger than those by LVG(P<0.05 or P<0.01).Conclusion: RT-3DE is a more accurate for evaluation of LV volume and EF in patients with aneurysm combined with myocardial infarction.