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目的探讨实时三维超声心动图(RT-3DE)评价心肌梗死(MI)和扩张型心肌病(DCM)患者左心室功能的可行性及价值。方法应用RT-3DE系统三维圆盘总和法分别测量26例MI组患者、10例DCM组患者及20例正常人(对照组)的左室舒张末期容积(LVEDV)、收缩末期容积(LVESV)和左室射血分数(LVEF),并与二维超声心动图(2-DE)双平面Simpson法和M型超声心动图(ME)Teichholz法的测值比较。结果①MI组、DCM组2-DE的LVEDV、LVESV测值低于RT-3DE;②MI组、DCM组ME的LVEDV、LVESV、LVEF测值高于RT-3DE;③RT-3DE、2-DE、ME显示MI组、DCM组患者LVEDV、LVESV均大于对照组,LVEF低于对照组,尤以DCM组为著。④对照组、MI组及DCM组RT-3DE与2-DE的LVEF测值高度相关;⑤对照组、MI组及DCM组RT-3DE与ME的LVEF测值高度相关。结论RT-3DE能显示心腔立体结构,较客观反映MI及DCM患者左心室功能的变化。
Objective To investigate the feasibility and value of real-time three-dimensional echocardiography (RT-3DE) in evaluating left ventricular function in patients with myocardial infarction (MI) and dilated cardiomyopathy (DCM). Methods LVEDV, LVESV and LVESV in 26 patients with MI, 10 patients with DCM and 20 normal controls (control group) were measured by RT-3DE system. Left ventricular ejection fraction (LVEF), and compared with two-dimensional echocardiography (2-DE) bi-planar Simpson method and M-mode echocardiography (ME) Teichholz method measured values. Results ① The LVEDV and LVESV values of 2-DE in MI group and DCM group were lower than those in RT-3DE group. ② The LVEDV, LVESV and LVEF values in ME group and DCM group were higher than those in RT-3DE group; ③RT-3DE, 2-DE, ME The results showed that LVEDV and LVESV in MI group and DCM group were higher than those in control group, LVEF was lower than that in control group, especially in DCM group. ④ The RT-3DE of the control group, MI group and DCM group were highly correlated with the LVEF of 2-DE. ⑤ The RT-3DE of the control group, MI group and DCM group were highly correlated with the LVEF of ME. Conclusion RT-3DE can display the three-dimensional structure of the heart chamber, which objectively reflects the changes of left ventricular function in patients with MI and DCM.