CAJ | 학술논문

目的探讨实时三维超声心动图(RT-3DE)评价扩张型心肌病(DCM)患者左室机械运动同步性的应用价值.方法采集28例DCM患者(DCM组)和29例正常人(对照组)实时三维全容积图像.由左室17节段容积-时间曲线测量各节段从心电图Q波起始点至收缩期最小容积时间(Tmsv),分别计算各组内1-17节段达收缩期最小容积的平均时间(Tmsv').推算左室3个短轴水平(基底水平、乳头肌水平和心尖水平)、12节段和16节段的同步性参数,同步性参数包括达收缩期最小容积时间标准差(Tmsv1-6-SD,Tmsv7-12-SD,Tmsv13-16-SD,Tmsv12-SD,Tmsv16-SD)和最大时间差(Tmsv1-6-Dif,Tmsv7-12-Dif,Tmsv13-16-DIF,Tmsv12-Dif,Tmsv16-Dif).结果对照组与DCM组分别进行组内17节段Tmsv'比较,差异均无统计学意义(P=1).DCM组左室各节段Tmsv'与对照组相应节段比较,差异均无统计学意义(P＞0.05).与对照组比较,DCM组左室各水平、12节段和16节段同步性参数均显著增高,除乳头肌水平同步性参数外(r=-0.402～-0.449,P＞0.05),其余均与RT-3DE所测左室射血分数呈显著线性负相关(r=-0.576～-0.768,P＜0.01或 P＜0.05).结论 DCM患者左室整体及各短轴水平内均存在机械运动不同步,RT-3DE可对其进行定量评价.
목적 탐토실시삼유초성심동도(RT-3DE)평개확장형심기병(DCM)환자좌실궤계운동동보성적응용개치.방법 채집28례DCM환자(DCM조)화29례정상인(대조조)실시삼유전용적도상.유좌실17절단용적-시간곡선측량각절단종심전도Q파기시점지수축기최소용적시간(Tmsv),분별계산각조내1-17절단체수축기최소용적적평균시간(Tmsv').추산좌실3개단축수평(기저수평、유두기수평화심첨수평)、12절단화16절단적동보성삼수,동보성삼수포괄체수축기최소용적시간표준차(Tmsv1-6-SD,Tmsv7-12-SD,Tmsv13-16-SD,Tmsv12-SD,Tmsv16-SD)화최대시간차(Tmsv1-6-Dif,Tmsv7-12-Dif,Tmsv13-16-DIF,Tmsv12-Dif,Tmsv16-Dif).결과 대조조여DCM조분별진행조내17절단Tmsv'비교,차이균무통계학의의(P=1).DCM조좌실각절단Tmsv'여대조조상응절단비교,차이균무통계학의의(P＞0.05).여대조조비교,DCM조좌실각수평、12절단화16절단동보성삼수균현저증고,제유두기수평동보성삼수외(r=-0.402～-0.449,P＞0.05),기여균여RT-3DE소측좌실사혈분수정현저선성부상관(r=-0.576～-0.768,P＜0.01혹 P＜0.05).결론 DCM환자좌실정체급각단축수평내균존재궤계운동불동보,RT-3DE가대기진행정량평개.
Objective To evaluate the left ventricular synchronicity in patients with dilated cardiomyopathy(DCM) by real-time three-dimensional echocardiography(RT-3DE).Methods Twenty-eight DCM patients and twenty-nine healthy volunteers were enrolled in this study,and clear full volume pictures were aquired using RT-3DE.The time to minimal systolic volume (Tmsv) of each segment was measured,and a mean value of Tmsv for the same segment in each group(Tmsv') was caculated.The standard deviation (Tmsv-SD) and the maximal difference (Tmsv-Dif) of Tmsv were calculated for basal level,mid level,apical lever,12 segments and 16 segments (Tmsv1-6-SD,Tmsv7-12-SD,Tmsv13-16-SD,Tmsv12-SD,Tmsv16-SD,Tmsv1-6-Dif,Tmsv7-12-Dif,Tmsv13-16-Dif,Tmsv12-Dif,Tmsv16-Dif).Results There were no significant differences among 1-17 Tmsv' within each group.No significant differences were found between two groups for Tmsv' derived from the same segment.All asynchrony indexs of DCM patients were remarkably higher than those of the healthy volunteers (P＜0.01 or P＜0.05),and correlated closely with LVEF determined by RT-3DE (r=-0.576～-0.768,P＜0.01 or P＜0.05) except for those of the mid level(r=-0.402～-0.449,P＞0.05).Conclusions Dyssynchrony exist in globle and each level of DCM patients' left ventricle.RT-3DE is an available technique for left ventricular synchronicity quantification.