CAJ | 학술논문

目的应用实时三维超声心动图(RT-3DE)容积-时间曲线评价扩张型心肌病(DCM)患者心脏同步化(CRT)术后左室舒张功能及舒张早期同步性变化以及二者间的关系.方法对39例DCM患者于术前及术后1周、6个月、12个月行RT-3DE检查,分析其容积-时间曲线,得出左心室16、12、6节段达舒张早期容积的时间标准差(Tedv-SD),用R-R间期标准化后,作为舒张早期不同步化指数(DDI),得出左室收缩末容积(LVESV)、舒张末容积(LVEDV)、射血分数(LVEF),并计算出舒张期峰值充盈率(PFR)、舒张期早期容积与舒张末期容积之比(EDV早/EDV).结果与CRT术前比较:术后1周LVEDV、LVESV无明显改善,而术后6个月及12个月明显改善(P＜0.05,P＜0.01);LVEF术后明显改善(P ＜0.05);术后6个月PFR增加(P＜0.05),EDV早/EDV于术后12个月显著减小(P＜0.01).各节段(Tedv-SD)/R-R术后1周显著缩短(P＜0.01).相关分析:CRT术前后△DDI与△EDV早/EDV减少呈显著正相关(r =0.52,P＜0.01),与△PFR呈负相关(r=-0.40,P＜0.05),△EDV早/EDV与△PFR之间也有良好的相关性(r=-0.56,P＜0.01).结论 DCM患者CRT术后左室同步性及舒张功能均得到改善,PFR、EDV早/EDV可作为评价左室舒张功能的有效指标.
목적 응용실시삼유초성심동도(RT-3DE)용적-시간곡선평개확장형심기병(DCM)환자심장동보화(CRT)술후좌실서장공능급서장조기동보성변화이급이자간적관계.방법 대39례DCM환자우술전급술후1주、6개월、12개월행RT-3DE검사,분석기용적-시간곡선,득출좌심실16、12、6절단체서장조기용적적시간표준차(Tedv-SD),용R-R간기표준화후,작위서장조기불동보화지수(DDI),득출좌실수축말용적(LVESV)、서장말용적(LVEDV)、사혈분수(LVEF),병계산출서장기봉치충영솔(PFR)、서장기조기용적여서장말기용적지비(EDV조/EDV).결과 여CRT술전비교:술후1주LVEDV、LVESV무명현개선,이술후6개월급12개월명현개선(P＜0.05,P＜0.01);LVEF술후명현개선(P ＜0.05);술후6개월PFR증가(P＜0.05),EDV조/EDV우술후12개월현저감소(P＜0.01).각절단(Tedv-SD)/R-R술후1주현저축단(P＜0.01).상관분석:CRT술전후△DDI여△EDV조/EDV감소정현저정상관(r =0.52,P＜0.01),여△PFR정부상관(r=-0.40,P＜0.05),△EDV조/EDV여△PFR지간야유량호적상관성(r=-0.56,P＜0.01).결론 DCM환자CRT술후좌실동보성급서장공능균득도개선,PFR、EDV조/EDV가작위평개좌실서장공능적유효지표.
Objective To evaluate the diastolic function and relationship between diastolic function and early diastolic synchrony in patients with dilated cardiomyopathy (DCM) by real-time three-dimensional echocardiography (RT-3DE) volume-time curves (VTC) after cardiac resynchronization therapy (CRT).Methods Thirty-nine patients with DCM were enrolled by RT-3DE VTC before and 1 week,6 months,12 months after CRT,draw the left ventricular (LV) 16,12,6 segments LV diastolic early volume standard deviation of the time (Tedv-SD),and with the R-R interval normalized as early diastolic unsynchronized index (DDI) ;draw end-systolic volume (LVESV),LV end-diastolic volume (LVEDV),LV ejection fraction (LVEF) ;and calculate the diastolic peak filling rate(PFR),the ratio of early diastolic volume and enddiastolic volume(EDVearly/EDV).Results LVEDV,LVESV had no significant improvement.Compared with the before and 1 week after CRT,but the improvement was statistically significant after 6 months and 12 months (P ＜0.05,P ＜0.01); LVEF after 1 week,6 months and 12 months were statistically significant (P ＜0.05) ;Compared with before,PFR after 6 months was significantly increased (P ＜0.05),EDVearly/EDV at 12 months after CRT was significantly reduced (P ＜ 0.01); There was a significantly shortened in each segment (Tedv-SD)/R-R 1 week after CRT (P ＜0.01),but the parameters had no obvious improvement later.Correlation analysis:△ DDI and △ EDVearly/EDV reduction was significant positive correlation (r =0.52,P ＜0.01),△DDI and PFR has negative correlation (r =-0.40,P ＜ 0.05),△ EDVearly/EDV and △PFR also had a good relationship (r =-0.56,P ＜0.01).Conclusions The LV synchrony and diastolic function were improved after CRT in patients with DCM; PFR,EDVearly/EDV can be used as evaluation of left ventricular diastolic function effectively targets.