实时三维超声心动图在肥厚型心肌病中的应用价值

目的探讨实时三维超声心动图(RT-3DE)在肥厚型心肌病(HCM)患者中的应用价值。方法选取肥厚型心肌病患者42例,另选健康体检者40名为对照组。全容量实时三维显示(full-volume),启动切割键(crop)对图像进行切割后,观察心腔立体形态及二尖瓣叶收缩期前向运动(SAM)现象,并将图像存储后于TomTec工作站进行分析。结果应用RT-3DE能清晰显示HCM患者心腔立体空间结构及SAM现象,并可以准确测量左心室舒张末容积(EDV)、收缩末容积(ESV)、每搏量(SV)和左心室射血分数(LVEF)等指标,结果显示:HCM组EDV(70.8±15.2)ml,SV(46.2±8.1)ml,与对照组比较均减低(均为P0.01),ESV(26.0±8.2)ml,EF64.4%±6.4%,与对照组比较差异无统计学意义(均为P0.05)。结论应用RT-3DE能够反映HCM患者心脏的立体空间结构,确定二尖瓣前叶运动与左心室流出道梗阻的关系,是准确评价HCM患者左心室收缩功能的方法。

The value of real-time three-dimensional echocardiography in patiens with hypertrophic cardiomyopathy

Objective To evaluate the value of real-time three-dimensional echocardiography （RT-3DE） in patients with hypertrophic cardiomyopathy （HCM）. Methods The study population consisted of 42 patients with HCM and 40 healthy volunteers. After starting full-volume of RT-3DE display and Crop key, then the stereoscopic views of HCM and phenomena of systolic anterior motion （SAM） were displayed clearly, the image was stored for analyzing in TomTec workstation. Results With RT-3DE, the stereoscopic views of HCM and phenomena of SAM could be displayed clearly, the end diastolic volume （ EDV ）, end systolic volume （ ESV ） , stroke volume （ SV ） and ejection fraction （ EF ） of left ventricle could be accurately measured. EDV [ （70.8 ± 15.2） ml] and SV [ （46.2 ± 8.1 ） ml] in HCM group were lower than in the normal control group （ both P 〈 0. 01 ）, while ESV [ （ 26. 0± 8. 2 ） ml ] and EF （ 64. 4% ± 6. 4% ） had no statistical difference between 2 groups （ both P 〉 0. 05 ）. Conclusions Application of RT-3DE can not only reflect the stereoscopic views of HCM but also determine the relationship between the anterior mitral leaflet movement and left ventricular outflow tract obstruction, and can accurately assess left ventricular systolic function in HCM patients.