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目的 探讨实时三维超声心动图 (RT 3DE)评价重构左室收缩功能的方法及可行性。方法 对 2 6例不同病因所致左室形态重构的患者 ,应用RT 3DE采集左室腔立体数据库 ,测量左室舒张末期容积 (EDV)、收缩末期容积 (ESV)和左室射血分数 (LVEF)。同时应用二维超声 ( 2DE)双平面Simpson’s法和M型 (ME)Teichholz法分别测量左室EF值。在心尖四腔、三腔和两腔心切面上 ,用ME记录二尖瓣瓣环在后间隔、侧壁、后壁、前间隔、下壁、前壁六个位点上运动的平均距离。分别比较RT 3DE与 2DE、ME测值的相关性。结果 RT 3DE能显示完整左室腔的立体形态。RT 3DE测定的LVEF值与二尖瓣瓣环运动的平均距离之间有很好的相关性 (r =0 .90 45 ,P <0 .0 0 1) ,与二维法及M型法测量值之间相关性较低(r =0 .73 5 5 ,r =0 .72 18,P <0 .0 1)。结论 RT 3DE为定量分析左室容积和收缩功能提供了一种无创的 ,准确可信的新途径。
Objective To investigate the feasibility and feasibility of using real-time three-dimensional echocardiography (RT 3DE) to evaluate remodeling of left ventricular systolic function. Methods Twenty-six patients with remnant left ventricular remodeling caused by different etiology were enrolled in this study. RT-3DE was used to collect left ventricular end-systolic volume (EDV), end-systolic volume (ESV) and left ventricular ejection fraction LVEF). Left ventricular EF values were measured by two-dimensional ultrasound (2DE) bi-planar Simpson’s method and M-type (ME) Teichholz method. The mean distance of mitral valve annulus motion at six sites of posterior septum, lateral wall, posterior wall, anterior septum, inferior wall and anterior wall was recorded with ME on the apical four-chamber, three-chamber and two-chamber coronal sections. The correlations between RT 3DE and 2DE and ME measurements were compared. Results RT 3DE can show the stereoscopic shape of the complete left ventricular cavity. There was a good correlation between the LVEF values measured by RT 3DE and the average distance of mitral valve annulus movement (r = 0.90 45, P <0 0 01) The correlation between values was lower (r = 0.73 5 5, r = 0.72 18, P <0 .01). Conclusion RT 3DE provides a noninvasive, accurate and credible new approach for the quantitative analysis of left ventricular volume and systolic function.