扩张型心肌病三维超声成像与左室质量重构研究

目的:探讨三维超声心动图(3DE)技术在诊断扩张型心肌病(DCM)中的实用性、准确性,并分析DCM左室重量(LVMASS)与左心功能的关系.方法:DCM组共39例,正常自愿组20例,均分别用二维超声心动图(2DE)、3DE测量LVMASS、左心功能,分别比较两组中2DE、3DE所得的LVMASS、左心功能;将3DE所测的LVMASS、左心功能作相关分析.结果:正常自愿组中2DE、3DE测量LVMASS、左心功能差异无统计学意义(P＞0.05),DCM组LVMASS及左室舒张、收缩末容积2DE、3DE所得值差异有统计学意义(P<0.05),2DE所得值有所低估,左心EF、SV的2DE、3DE各所得值差异无统计学意义(P＞0.05),3DE所得LVMASS与左心功能EF呈负相关(r＝-0.897).结论:3DE重建DCM左心室安全、准确、可行,能较准确地判断DCM的心肌重量、心功能.对心腔明显扩大变形者3DE测值有异于2DE,2DE可能低估测值.LVMASS与左心功能呈负相关,有效减少LVMASS可改善左心功能.

RESEARCH OF THREE-DIMENSIONAL ECHOCARDIOGRAPHY AND LEFT VENTRICULAR MASS RECONSTRUCTION IN PATIENTS WITH DILATED CARDIOMYOPATHY

Objective:To study the applicability and accuracy of three-dimensional echocardiography(3-DE) in diagnosis of patient with dilated cardiomyopathy and to investigate the correlation between left ventricular mass and left ventricular function.Methods:Thirty-nine patients with dilated cardiomyopathy(DCM) and 20 healthy volunteers underwent two-and three-dimensional echocardiography for measurement of left ventricular mass and left ventricular function. Data of three-dimensional echocardiography were processed by TomTec imaging systems. Left ventricular mass and left ventricular function were compared between two- and three-dimensional echocardiography. Correlation between leftventricular mass and left ventricular function measured at three-dimensional chocardiography was calculated.Result:There was no significant difference in measurements of left ventricular mass and left ventricular function in healthy volunteers between two- and three-dimensional echocardiography. There was a significant difference in left ventricular mass, LVEDV, and LVESV in patients with dilated cardiomyopathy between two- and three-dimensional echocardiography;but the difference in EF and SV was not significant. A significant correlation was obtained between left ventricular mass and left ventricular function in patients with dilated cardiomyopathy at three-dimensional echocardiography.Conclusion:Three-dimensional echocardiography can rebuild left ventricle in patients with DCM accurately and safely. Left ventricular mass and left ventricular function in patients with DCM can be accurately determined by transthoracic three-dimensional echocardiography.Three-dimensional echocardiography is preferable to two-dimensional echocardiography in deformed or dilated ventricle.There is a significant correlation between left ventricular mass and left ventricular function.Reduction of left ventricular mass can improve left ventricular function.