实时三维超声心动图容积-时间曲线定量评价陈旧性心肌梗死患者左室舒缩功能及室壁运动的同步性

目的利用实时三维超声心动图容积-时间曲线，评价陈旧性心肌梗死患者左室整体收缩与舒张功能及室壁运动同步性的变化。方法陈旧性心肌梗死患者30例，正常对照组25例，全容积采集图像，进行容积-时间曲线分析，记录左室舒张末容积（EDV）、左室收缩末容积（ESV）、左室射血分数（LVEF）、左室最大射血速率（PER）、左室最大充盈速率（PFR）；左室16节段达到最小收缩容积时间的标准差值和最大差值被标准化为心动周期的百分比（Tmsv16-SD％、Tmsv16-Dif％）。结果与正常对照组比较，心肌梗死组EDV、ESV、Tmsv16-SD％、Tmsv16-Dif％均显著增高（P〈0．05）；LVEF、PER／EDV、PFR／EDV显著降低（P〈0．05）；PER／EDV、PFR／EDV与LVEF均呈显著正相关，PER／EDV与PFR／EDV之间也呈显著正相关，LVEF与Tmsv16-SD％、Tmsv16-Dif％均呈显著负相关。结论实时三维超声心动图容积-时间曲线参数可以准确、客观地评估陈旧性心肌梗死患者左室收缩与舒张功能以及室壁运动同步性。

Quantitative assessment of left ventricular systolic and diastolic function and wall motion synchronism in patients with old myocardial infarction by real -time three-dimensional echocardiography volume-time curve

Objective To assess the change of left ventricular global systolic and diastolic function and wall motion synchronism in patients with old myocardial infarction by real - time three - dimensional echocardiography volume - time curve （RT- 3DE）. Methods thirty patients with old myocardial infarction and twentyfive normal subjects were enrolled in this study. Their sonograms were obtained by full volume RT- 3DE, then analyzed by volume -time curve. The end diastolic volume （EDV）, end systolic volume（ESV）, left ventricular ejection fraction（LVEF） , left ventricular peak ejection rate （PER）, left ventricular peak flow rate（ PFR）, the time of minimal systolic volume of 16 - segmental＇ standard deviation （Tmsv16 - SD）, difference（Tmsv16- Dif） were recoreded. Results Compared with control group, EDV, ESV, Tmsv16 -SD%, Tmsv16 - Dif% were increased, and LVEF, PER/EDV, PFR/EDV were decreased in old myocardial infarction group （ P 〈 0.05 ）. There was positive correlation among PER/EDV, PFR/EDV and LVEF, while there was negative correlation between LVEF and Tmsv16 - SD%, Tmsv16 - Dif%. Conclusion RT - 3DE can assess left ventricular systolic and diastolic function and wall motion synchronism in patients with old myocardial infarction accurately and objectively.