摘要
目的探讨实时三维超声心动图在评价不同QRS波时限的心力衰竭患者左室收缩功能及其同步性上的可行性和临床价值。方法 27例正常对照组(A组)及35例病例组(B组)均进行二维和三维超声心动图检查;依据QRS宽度将B组分为B1组、B2组。获取各组的左室射血分数(LVEF)、左室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV);应用Qlab软件描绘左室容量-时间曲线,计算左室16节段、12节段收缩期容积达峰时间的标准差(Tmsv-SD)、最大差异(Tmsv-Dif)及其标准化值(Tmsv-SD%、Tmsv-Dif%);常规体表心电图记录QRS时限。结果①B1、B2两组LVEF、LVEDV、LVESV及收缩同步性参数与A组比较,差异均有统计学意义(P<0.05)。②A组左室收缩均呈同步性,B1组中33%的患者收缩不同步,B2组中78%的患者收缩不同步。结论①无论心力衰竭患者的QRS波时限增宽与否,均有一定比例患者存在心脏运动不同步现象。②RT-3DE能够准确评价不同宽度QRS时限心衰患者的心肌收缩同步性。
Objective To explore feasibility and clinical value of real-time three-dimensional echocardiography in the evaluation of different QRS wave time in heart failure patients with left ventrieular systolic function and movement synchroniza- tion. Methods 30 cases of healthy volunteers （group A） and 30 cases of heart failure patients （group B） underwent RT-3DE inspection. B group was divided into B1, B2 group according to the QRS time, all groups were analyzed by real-time three-di- mensional echocardiography, obtained the left ventricular ejection fraction （LVEF）, left ventricular end-diastolicolume（EDV）, end-systolic volume （ESV）. Application Qlab technology describe left ventricular capacity time curve, the calculation of the left ventricle in 16 segment, 12 segment of systolic volume tmax standard deviations （Tmsv-SD）, maximum difference （Tmsv-Dif） and its standardization value （Tmsv-SD%, Tmsv-Dif% ） as left ventricular contraction out-of-step indicator. Recorded QRS time limit of conventional body surface electrocardiogram. Results ①There was statistical significance between A, B groups in LVEF, LVEDV, LVESV and index of shrinkage not synchronous （P〈0.05）. ②Left ventricular contraction of A group were in sync,the shrinkage of 33% patients in B1 group were not synchronized, the shrinkage of 78% patients in B2 group were not synchronized. Conclusion ①No matter QRS broadening or not in patients, all have the certain proportion exists in dyssyn- chrony. ② RT-3DE can assessed left ventricular contraction synchronism of different width QRS wave and guide clinical imple- ment cardiac resynchronization therapy （CRT）.
出处
《中国现代医药杂志》
2013年第1期14-16,共3页
Modern Medicine Journal of China
关键词
心衰
左心功能
实时三维
同步性
Chronic heart failure Left ventricular function Real-time three-dimensional Dyssynchrony
