实时三维超声心动图定量评价慢性心力衰竭患者左房功能

目的:探讨实时三维超声心动图(RT-3DE)评价慢性心力衰竭(CHF)患者左房功能的价值。方法:使用二维超声心动图(2DE)、RT-3DE分别测量28例CHF患者和31例正常人的左房最大容积(LAVmax)、最小容积(LAVmin)及左房收缩前容积(LAVp),计算左房各期的射血分数(LAEF)和左房最大容积指数(LAVI)。二维超声心动图频谱多普勒(PW)测量舒张早期二尖瓣口血流E峰,用组织多普勒成像(PW-TDI)测量二尖瓣环舒张早期运动速度e’,计算E/e’。结果:两组间一般临床资料如年龄、性别、体表面积比较差异无统计学意义(P>0.05);两组间测量结果比较差异明显,均有统计学意义(P<0.05);两种方法测量两组患者LAVmax相关性显著;两组的LAVI与E/e’相关性显著。结论:RT-3DE能定量评价慢性心力衰竭患者左房容积和功能,对判断左室舒张功能及预测未来心血管事件具有重要意义。

Assessment of Left Atrial Function in Patients with Chronic Heart Failure by Real-Time Three-Dimensional Echocardiography

Objective: To evaluate left atrial(LA) function in patients with chronic heart failure by real-time three-dimensional echocardiography(RT-3DE).Methods: Twenty-eight patients with chronic heart failure(CHF) and thirty normal subjects were examined by two-dimensional echocardiography(2DE) and RT-3DE to determine their maximum volume of LA(LAVmax),minimum volume(LAVmin) and pre-atrial contraction volume(LAVp),and the LA ejection fraction(LAEF) and maximum volume index(LAVI) were also calculated.With 2DE pulsed-wave Doppler(PW) and the pulsed-wave tissue Doppler imaging(pw-TDI),the peak flow velocities(E) and the mitral annulus velocity(e’) during early diastole were recorded and E/e’ was calculated.Results: There was no significant difference among the two groups in clinical data(P>0.05).There was significant difference in results observed by RT-3DE and by 2DE between the two groups(P<0.05).There was a significant correlation between 2DE and RT-3DE in measuring LAVmax.There was a significant correlation between LAVI and E/e’.Conclusion: RT-3DE can evaluate the LA volume and function in patients with CHF,it’s very important to estimate the function of left ventricular diastole and to predict cardiovascular events.