实时三维超声心动图评价缺血性心肌病心力衰竭患者左室收缩同步性.pdf

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1、临床超声医学杂志2015年2月第l7卷第2期JClinUltrasoundinMed，Feburary2015，Vo1．17，No．2·121··经验交流·实时三维超声心动图评价缺血性心肌病心力衰竭患者左室收缩同步性周小芳孙海燕王亮姜淑英黄福光寇红菊摘要目的应用实时三维超声心动图评价缺血性心肌病(ICM)所致慢性心力衰竭患者左室收缩同步性，并分析收缩不同步性指数(SDI)与左室射血分数(LVEF)的相关性。方法选择缺血陛心肌病引起心力衰竭患者53例为ICM组，体检健康者50例为对照组。应用实时三维超声心动图测量其左室舒张末容积(EDV)、收缩末容积(ESV)和LVEF，16节段(

2、除外心尖帽)收缩达最小容积时间的标准差并以R—R间期校正后百分数作为左室SDI。结果与对照组比较，ICM组EDV增高，LVEF降低，左室SDI增高，差异均有统计学意义(．01)。ICM组SDI与LVEF呈高度负相关(r=-O．72，／L-O．000)，对照组SDI与LVEF呈低度负相关(，=：一0．31，P=0．020)。结论ICM心力衰竭患者相较对照组左室内存在明显收缩不同步，且SDI与左室收缩功能存在负相关。关键词超声心动描记术，实时，三维；心室，左；收缩不同步；心力衰竭[中图法分类号]R657．51；R445．1[文献标识码]AAssessmentofleftventric

3、ularsystolicdyssynchronyinheartfailurepatients、thischemiccardiomyopathyusingreal-timethree-dimensionalechocardiographyZhouXiaofang，SunHaiyan，WangLiang，JiangShuying，HuangFuguang，KouHongjuDepartmentofUtrasound，theSecondAfiliatedHospitalofWenzhouMedicalCollege，Wenzhou325027，ChinaABSTRACTObjectiv

4、eToinvestigatetheleftventrieularsystolicdyssynchmnyinheartfailurepatientswitllischemiccardiomyopathy(ICM)andanalyzethecorrelationbetweenthesystolicdyssynehronyindex(SDI)andtheleftventricularejectionfraction(LVEF)．MethodsFifty-threeheartfailurepatientscausedbyICMwereincludedinICMgroup．fiftyhea

5、lthysubjectswereenroledascontrolgroup．Theend-diastolicvolume(EDV)，end-systolicvolume(ESV)andleftventricularejectionfraction(LVEF)wereobtainedusingreal-timethree—dimensionalechocardiography(RT-3DE)．Standarddeviationoftime-to-minimal-systolic-volumeof16一LVsegmentscorrectedbyR-Rintervalwascalcul

6、atedassystolicdyssynchmnyindex(SDI)ofLV．ResultsEDVandSDIofICMgroupwerehigherthanthoseofcontrolgroup，LVEFwaslowerthanthatofcontrolgroup．SDIinICMgroupshowedahighlevelofnegativecorrelationwithLVEF(r=-0．72，P=0．00o)．SDIincontrolgroupshowedalowlevelofnegativecorrelationtIlLVEF(r=-O．31，P=0．020)．Conc

7、lusionComparedwitllcontrolgroup，leftventricularsystolicdyssynchmnyexistsinheartfailurepatientscausedbyICM，SDIshowsnegativecorrelationwithLVsystolicfunction．KEYWORDSEchocardiography，real-time，three-dimensional；Ventricle，left；Systolicdyssynehro