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实时三维超声心动图评价扩张型心肌病左心房同步性价值初步研究

邓燕   

  1. 广西医科大学第一附属医院超声科
  • 收稿日期:2010-04-16 修回日期:2010-06-07 出版日期:2010-11-15 发布日期:2010-11-15
  • 通讯作者: 邓燕

Initial Study of Real-time Three-dimensional echocardiography Assessment of Left atrial Synchronicity in Patients with Dilated Cardiomyopathy

deng yan   

  • Received:2010-04-16 Revised:2010-06-07 Published:2010-11-15 Online:2010-11-15
  • Contact: deng yan

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摘要： 摘要 目的:探讨实时三维超声心动图(RT-3DE)评价扩张型心肌病（DCM）左心房内同步性的临床应用价值。方法:选择DCM组共31例和正常人30例，应用RT-3DE测量左心房16节段、12节段、6节段QRS起点达最小收缩容积时间标准差（Tmsv 16-SD、Tmsv 12-SD、Tmsv 6-SD）及离均差（Tmsv 16-Dif、Tmsv 12- Dif、Tmsv 6- Dif），测量左心房最大容积（LAVmax）、最小容积（LAVmin）及收缩前容积（LAVpre），计算左心房整体射血分数（LAEF）、被动射血分数（LAEFpassive）及主动射血分数（LAEFactive）。结果:与正常组比，DCM组左心房16节段、12节段及6节段不同步参数较正常组明显增大（均P<0.05）；LAVmax、LAVpre、LAVmin指数较正常组增大，而LAEF、LAEFpassive、LAEFactive较正常组降低（均P<0.05）。左心房不同步参数与心房容积与功能均存在一定相关关系，其中，左心房Tmsv16-SD、Tmsv 16Dif 与LAVmax指数呈正相关（r分别为0.71、0.74，均 P<0.01）, 与LAEF呈负相关（r分别为-0.69、-0.72,均P<0.01）。结论: RT-3DE可准确检测DCM左房机械运动不同步情况，左心房内机械运动不同步与左心房扩大及整体功能降低关系密切。

关键词: 心肌病, 扩张型, 心房功能, 左, 超声心动描记术, 三维, 心房颤动, 心电描记术

Abstract: Abstract Obiective： To evaluate left atrial asynchrony in patients with dilated cardiomyopathy (DCM) by real-time three-dimensional echocardiography (RT-3DE). Methods：Thirty-one patients with DCM and thirty healthy subjects underwent RT-3DE. Left atrial 16-, 12-, 6- segment models asynchrony parameters including the standard deviation（Tmsv 16-SD、Tmsv 12-SD、Tmsv 6-SD） and maximal difference of QRS to Tmsv（Tmsv 16-Dif、Tmsv 12- Dif、Tmsv 6- Dif）were measured, and maximun left atrial volume index(LAVmax index), minimum atrial volume (LAVmin index), volume before atrial active contraction (LAVpre index) were measured. Left atrial emptying passive atrial emptying fraction(LAEF), passive atrial emptying fraction (LAEFpassive), active atrial emptying fraction (LAEFactive) were calculated. Results： Left atrial 16-, 12-, 6- segment models asynchrony parameters were significantly higher in the DCM group than those in the control（P<0.05）. LAVmax index, LAVpre index and LAVmin index were higher, whereas LAEF, LAEFpassive、LAEFactive were lower in the DCM groups than those in the control group（P<0.05）. Moreover, there were correlation between left atrial 16-, 12-, 6- segment models asynchrony parameters and left atrial volume and function. There were positive correlations between left atrial Tmsv16-SD，Tmsv 16Dif and LAVmax index（r=0.71、0.74, P<0.01, respectively）, and negative correlations between left atrial Tmsv16-SD,Tmsv 16 Dif and EF（r=-0.69、-0.72, P<0.01，respectively）. Conclusion： RT-3DE is a useful ultrasonic technique that can allow accurate evaluation of left atrial asynchrony in patients with dilated cardiomyopathy, left atrial asynchrony have intenly relation with left atrial dilate and decrease atrial function.

Key words: cardiomyopathy, dilatedatrial function, leftechocardiography, three-dimensionalatrial fibrillationelectrocardiography Atrial, Synchronicity, 心电描记术