| 摘要: |
| 目的 探讨实时三维超声心动图（RT-3DE）对经皮左室重建术（PVR）后心脏形态及功能评价的应用价值。方法 陈旧性前壁心肌梗死合并室壁瘤的患者7例进行PVR术。应用RT-3DE评估患者术前、术后6个月左室形态变化、收缩功能及同步性。RT-3DE 测量心率校正的 16、12 节段达收缩末最小容积的标准差和最大差值(Tmsv16-SD%、 Tmsv16-Dif%、Tmsv12-SD%、Tmsv12-Dif%)作为收缩同步性参数。结果 术后6个月NYHA心功能分级较术前明显下降，6分钟步行距离较术前明显升高。 术后7例患者三维左室形态明显改善，心尖部室壁瘤被有效隔离。术后RT-3DE测得左室收缩功能指标（3D-EF、3D-EDV 及3D-ESV）均得到明显改善(P＜0.05)。校正的左室16节段收缩同步性参数（Tmsv16-SD%、Tmsv16-Dif%）明显缩短（P<0.05）。结论 PVR是一种安全有效的微创介入治疗室壁瘤方法，RT-3DE可以更准确评价PVR术后心脏形态，左室收缩功能及同步性。 |
| 关键词: 超声心动描记术 三维 经皮左室重建术 左室收缩同步性 |
| DOI： |
| 投稿时间：2017-09-15修订日期：2017-09-15 |
| 基金项目:国家自然科学基金青年科学基金项目 |
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| Assessment of left ventricular systolic function and synchrony in patients with percutaneous ventricular restoration by real-time three-dimensional echocardiography |
| yanguohui,chenjianghua |
| (Zhongshan Hospital Xiamen University) |
| Abstract: |
| Abstract Objective To assess the value of real-time three-dimensional echocardiography (RT-3DE) in evaluating left ventricular (LV) systolic function in ischemic heart failure patients with apical aneurysm after percutaneous ventricular restoration(PVR). Methods Seven patients with anterior wall myocardial infarction complicated apical aneurysm were selected for implanting Parachute. Heart failure symptoms were evaluated using the NYHA class, functional exercise capacity was assessed through the six-minute walk test. LV ejection fraction(3D-EF), LV end diastolic volume(3D-EDV) , LV end systolic volume(3D-ESV) and the standard deviation(SD) and difference (Dif) of the time to the point with minimal systolic volume (Tmsv)in 16 and 12 segments adjusted by the R-R interval(Tmsv16-SD%, Tmsv16-Dif%, Tmsv12-SD%, Tmsv12-Dif%), that was the index of LV systolic synchrony, were measured by using RT-3DE before and 6 months after the operation. Results Post-procedure NYHA class reduced and six-minute walk test increased evidently compared to pre-procedure (P＜0.05). LV apical geometry recovered and LV systolic function(3D-EF, 3D-EDV and 3D-ESV) improved significantly after PVR(P＜0.05). The index of LV systolic synchrony, Tmsv16-SD% and Tmsv16-Dif% were reduced markedly compared to pre-procedure (all P＜0.05). Conclusions PVR was relatively safe and effective for apical aneurysm theraphy. RT-3DE can accurately evaluate LV systolic function and systolic synchrony after PVR. |
| Key words: Echocardiography three-dimensional percutaneous ventricular restoration left ventricular systolic synchrony |
