目的: 应用单心动周期实时三维超声心动图(single beat real-time three-dimensional echocardiography, sRT-3DE)评价扩张型心肌病(dilated cardiomyopathy, DCM)患者左、右心室的收缩功能及左心室收缩同步性。方法: 对17例DCM患者和17 名年龄性别相匹配的健康对照者行sRT-3DE检查,通过专有软件分析获得以下参数。①左心室常规容积参数,包括左心室舒张末期和收缩末期的容积、左心室每搏输出量和射血分数(ejection fraction,EF);②左心室几何形态学参数,包括收缩末和舒张末的球形指数;③左心室收缩期节段容积变化同步性参数,包括收缩期失同步指数(systolic dyssynchrony index,SDI)、收缩末离散差、收缩后和收缩前的时间容积及平均收缩时间;④右心室容积参数,包括右心室舒张末期和收缩末期容积、右心室每搏输出量和EF。各项容积参数按照体表面积进行标化。结果: 与对照组相比,DCM组标化的左、右心室舒张末期和收缩末期容积均增大,左、右心室EF均减小(P均<0.01);左心室舒张末和收缩末的球形指数均增大(P均<0.01);SDI、收缩末离散差、收缩前及收缩后时间容积均增大(P均<0.01)。采用sRT-3DE检查评价左、右心室收缩功能和左心室同步性平均费时仅需5 min。结论: sRT-3DE能够揭示DCM患者左、右心室的收缩功能及左心室同步性异常,且检查费时少,或可常规应用于DCM患者的心功能评估及随访。
Objective: To assess the ventricular systolic function and left ventricular synchrony in patients with dila-ted cardiomyopathy using single beat real-time three-dimensional echocardiography (sRT-3DE). Methods: Seventeen patients with dilated cardiomyopathy (DCM group) and seventeen healthy subjects (control group, age and sex matched) undergone sRT-3DE examination were enrolled in this study.Full-volume imaging was performed and the data were analyzed by left ventricular analysis software and right ventricular analysis software. Results: ① The parameters of left ventricular volume: In DCM group, the end systolic volume and diastolic volume were larger and the ejection fraction was lower than that of the control group (P<0.01). ②The parameters of left ventricular geometry: In DCM group, the end systolic sphericity index and end diastolic sphericity index were larger than that of the control group (P<0.01). ③ The systolic synchrony parameters were significantly larger in DCM group (P<0.01). ④ The parameters of right ventricular volume: In DCM group, the systolic volume and diastolic volume were larger and the ejection fraction was lower than that of the control group (P<0.01). Conclusions: sRT-3DE can accurately and rapidly assess the ventricular systolic function and left ventricular synchrony in patients with dilated cardiomyopathy. Thus, it's a useful and feasible routine quantification technique in patients with DCM in clinical practice.
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