三维超声心动图评估心肌梗死后左心室功能及室壁运动同步性的变化

目的 探讨应用实时三维超声心动图(RT-3DE),评价急性心肌梗死(AMI)患者左心室收缩舒张功能及收缩同步性的价值。方法 选择2013年1月~2014年5月于笔者医院心内科住院治疗急性前壁心肌梗死的患者51例(A组),健康志愿者25例(B组),均行常规二维及RT-3DE检查,通过Qlab 6.0定量分析软件分析整体及节段容积-时间曲线,获取左心室整体和节段舒张末期容积、整体和节段收缩末期容积、左心室整体-节段及节段-整体的射血分数、左心室最大射血速率和充盈速率以及Tmsv16-SD。结果 与健康志愿者相比,AMI患者左心室整体EDV、ESV、Tmsv16-SD%水平均增高,LVEF、PER/EDV、PFR/EDV水平均下降(P均<0.05),梗死节段及邻近梗死区域的大部分rEDV、rESV增高,rEF、rgEF均下降(P<0.05)。结论 RT-3DE能够评价AMI患者左心室舒缩功能及室壁运动同步性。

Assessment of Left Ventricular Function and Wall Motion Synchronization Changes after Myocardial Infarction by Three-dimensional Echocardiography.

Objective To investigate the assessment value of left ventricular systolic and diastolic function and wall motion synchronization in patients with AMI by RT-3DE. Methods Patients with acute anterior myocardial infarction(n=51) who accepted treatments in our hospital between January 2013 and May 2014, and healthy volunteers(n=25) were recruited. All of them were given conventional two-dimensional and RT-3DE examination. Overall and segmental volume-time curves were analyzed by Qlab 6.0 Quantitative Analysis Software and the data of EDV,rEDV, ESV, rESV, rEF, rgEF, PER, PFR and Tmsv16-SD were got. Results Compared with B group, the levels of left ventricular EDV, ESV and Tmsv16-SD% in AMI group were significantly higher, while the levels of LVEF, PER/EDV and PFR/EDV in AMI group were significantly lower(P<0.05). Compared with the normal control group, the rEDV and rESV of infarction infarcted segments and most of neighboring regions increased greatly, while the rEF, rgEF decreased greatly(P<0.05). Conclusion RT-3DE can evaluate systolic and diastolic function of left ventricular and wall motion synchronization of the patients with AMI.