CAJ | 학술논문

目的应用实时三维超声心动图(RT-3DE)评价陈旧性心肌梗死患者左心室收缩同步性与收缩功能,并探讨左心室收缩同步性对左心室整体及局部收缩功能的影响.方法对陈旧性心肌梗死组30例(心梗组,其中陈旧性前壁心梗14例)及20名正常人(正常组)行RT-3DE检查,通过脱机软件分析整体及节段容积-时间曲线,获取左心室整体及节段收缩功能参数、左心室收缩同步性参数.结果心梗组左心室ESV、EDV显著大于正常组(P＜0.01),LVEF显著小于正常组(P＜0.001).心梗组左心室16及12节段收缩同步性参数显著大于正常组(P＜0.001),且均与LVEF呈负相关,其中Tmsv-16-SD%、Tmsv-16-Dif%相关性最高,r值分别为-0.755、-0.747.前壁心梗组梗死节段及邻近节段rEF、rgEF显著减低(P＜0.05),Tmsv%明显延长(P＜0.05),部分未梗死节段Tmsv%出现不同程度缩短,但差异无统计学意义,且前壁心梗组Tmsv% 明显延长的节段与rEF、rg-EF明显减低的节段基本呈对应关系.结论 RT-3DE能定量评价心肌梗死患者左心室收缩同步性及收缩功能,左心室不同步运动可影响左心室收缩功能.
목적 응용실시삼유초성심동도(RT-3DE)평개진구성심기경사환자좌심실수축동보성여수축공능,병탐토좌심실수축동보성대좌심실정체급국부수축공능적영향.방법 대진구성심기경사조30례(심경조,기중진구성전벽심경14례)급20명정상인(정상조)행RT-3DE검사,통과탈궤연건분석정체급절단용적-시간곡선,획취좌심실정체급절단수축공능삼수、좌심실수축동보성삼수.결과 심경조좌심실ESV、EDV현저대우정상조(P＜0.01),LVEF현저소우정상조(P＜0.001).심경조좌심실16급12절단수축동보성삼수현저대우정상조(P＜0.001),차균여LVEF정부상관,기중Tmsv-16-SD%、Tmsv-16-Dif%상관성최고,r치분별위-0.755、-0.747.전벽심경조경사절단급린근절단rEF、rgEF현저감저(P＜0.05),Tmsv%명현연장(P＜0.05),부분미경사절단Tmsv%출현불동정도축단,단차이무통계학의의,차전벽심경조Tmsv% 명현연장적절단여rEF、rg-EF명현감저적절단기본정대응관계.결론 RT-3DE능정량평개심기경사환자좌심실수축동보성급수축공능,좌심실불동보운동가영향좌심실수축공능.
Objective To assess left ventricular systolic synchrony and systolic function, as well as the relationship between left ventricular systolic synchrony and systolic function in patients with myocardial infarction with real-time three-dimensional echocardiography (RT-3DE). Methods Thirty patients with myocardial infarction and 20 healthy subjects underwent RT-3DE. Full-volume imaging was performed and the data was analyzed. A series of global and regional left ventricular volume curves were plotted. The parameters of left ventricular systolic function, synchrony in global and regional cardiac ventricle were obtained. Results ESV, EDV were larger and the LVEF was lower in the group of patients with myocardial infarction than those of the control group (P＜0.01). All the systolic synchrony parameters were significant larger in patients with myocardial infarction than in the control group (P＜0.001). The LVEF values, especially Tmsv-16-SD% and Tmsv-16-Dif%, were negative correlated with all the systolic synchrony parameters (r=-0.755, -0.747). The regional left ventricular systolic function parameters (rEF and rgEF) were lower and the Tmsv% was longer (P＜0.05) in the zones with infarction in patients with anterior myocardial infarction than those of the control group. The changes of Tmsv% were in coincidence with that in regional left ventricular systolic function. Conclusion RT-3DE can be used to evaluate left ventricular systolic synchrony and systolic function. The left ventricular systolic asynchrony has negatively effect on systolic function.