Background Regional ejection fraction （EFR） measured by real-time three-dimensional echocardiography （RT-3DE） provides a novel method for quantifying left-ventricular （LV） regional systolic function. We aimed to...Background Regional ejection fraction （EFR） measured by real-time three-dimensional echocardiography （RT-3DE） provides a novel method for quantifying left-ventricular （LV） regional systolic function. We aimed to explore the diagnostic value of regional ejection fraction （EFR） derived from RT-3DE in detecting LV aneurysms in patients with myocardial infarction. Methods Thirty-eight patients with myocardial infarction were prospectively enrolled and underwent electrocardiography （ECG）, two-dimensional echocardiography （2-DE）, RT-3DE and left ventriculography （LVG）. Subjects with a negative EFR in at least one segment on RT-3DE were considered as having a ventricular aneurysm. We compared the sensitivity, specificity, Youden＇s index, and positive and negative predictive values of ECG, 2-DE and RT-3DE in determining LV aneurysm with detection by LVG. Results On LVG an LV aneurysm was diagnosed in 16 （42.1%） patients. The sensitivity and specificity were 62.5% and 86.4% for ECG, 81.2% and 95.4% for 2-DE, and 100.0% and 90.9% for RT-3DE in diagnosing LV aneurysm. Youden＇s indexes for ECG, 2-DE and RT-3DE were 0.49, 0.77 and 0.91, respectively. Positive and negative predictive values were 76.9% and 76.0% for ECG, 92.9% and 87.5% for 2-DE, and 88.9% and 100.0% for RT-3DE. Conclusions RT-3DE-derived EFR provides a novel, reliable index in the diagnosis of LV aneurysm and has excellent sensitivity and specificity.展开更多
目的 探究三维超声心动图检查对急性心肌梗死(AMI)患者左心室重构和心功能的评估价值。方法 选取2018年2月至2019年2月宝鸡市中医医院收治的AMI且择期接受经皮冠状动脉介入术(PCI)治疗的患者206例,根据患者是否发生左心室重构分为重构组...目的 探究三维超声心动图检查对急性心肌梗死(AMI)患者左心室重构和心功能的评估价值。方法 选取2018年2月至2019年2月宝鸡市中医医院收治的AMI且择期接受经皮冠状动脉介入术(PCI)治疗的患者206例,根据患者是否发生左心室重构分为重构组(n=69)和非重构组(n=137)。所有患者入院后48 h内及术后均接受单光子发射计算机断层成像术(SPECT)和三维超声心动图检查,比较两组患者左心室功能参数、三维斑点追踪参数和血清左心室重构指标的差异;采用Pearson相关性分析超声心动图检查与SPECT检查左心室功能参数、三维斑点追踪参数与血清左心室重构指标的相关性。结果 重构组和非重构组患者采用三维超声心动图检查的左室收缩末期容积(LVESV) [(53.27±10.68) mL vs (48.76±9.54) m L]、左室心肌质量(LVM) [(181.54±13.47) g vs(177.46±11.63) g]和左心室质量指数(LVMI) [(135.47±7.23) g/m~2vs (131.54±8.41) g/m~2]比较,重构组明显高于非重构组,左室射血分数(LVEF) [(49.43±6.37)% vs (52.37±7.84)%]、左室整体纵向峰值应变(GLS) [(9.52±1.23) vs (11.87±1.34)]、整体径向峰值应变(GRS) [(29.26±5.56) vs (33.25±6.14)]和整体面积峰值应变(GAS) [(14.21±2.25) vs (18.64±3.18)]比较,重构组明显低于非重构组,差异均有统计学意义(P<0.05);重构组和非重构组患者的血清基质金属蛋白酶 9 (MMP9) [(56.78±9.16) ng/mL vs (48.14±7.45) ng/mL]、成纤维细胞生长因子 23 (FGF23) [(886.47±98.63) pg/mL vs (782.16±95.41) pg/mL]和I型C 端胶原前肽(PICP) [(12.15±2.13) ng/mL vs (9.76±2.21) ng/mL]水平比较,重构组明显高于非重构组,差异均有统计学意义(P<0.05);经Pearson相关性分析结果显示,三维超声心动图检查的LVEDV、LVESV、LVEF指标与SPECT检查结果具有良好的相关性(P<0.01),患者的三维斑点追踪参数GLS、GRS、GAS与血清MMP9、FGF23、PICP水平呈负相关(P<0.05)。结论 三维超声心动图检查可用于�展开更多
Background Real-time three-dimensional echocardiography （RT-3DE） has made revolutionized improvements of cardiac imaging during the past few years. However, there is no standard examination method for RT-3DE so far....Background Real-time three-dimensional echocardiography （RT-3DE） has made revolutionized improvements of cardiac imaging during the past few years. However, there is no standard examination method for RT-3DE so far. This study aimed to establish the diagnostic method of RT-3DE and evaluate its application in the diagnosis of complex congenital heart diseases （CHD）. Methods Fifty patients with complex CHD were examined by RT-3DE with modes of Live 3DE and Full Volume. A series of novel volumetric views combined with Van Praagh sequential segmental approach were introduced to reveal the pathological morphology of the hearts, which were compared with the findings of two-dimensional echocardiography （2DE）, angiography and cardiac surgery. Results In 50 patients, 190 image acquisitions of Full Volume were performed at several acoustic windows including subcostal, apical and parasternal regions. Among them, 94.2% （179/190） of image acquisitions were successful. Most sectional volumetric views could be clearly displayed in 92.6% of the successful image acquisitions. However, sectional volumetric views could not be clearly displayed in 7.4%, which was mainly due to poor perspective conditions of examination location, improper instrument multi-parameter setting and insufficient information of whole heart captured in Full Volume acquisitions. As compared with surgical findings and angiography, RT-3DE made correction to the diagnoses in 2 cases including 1 with corrected transposition of the great arteries and the other with single atrium and mitral cleft. The diagnoses initially made by 2DE for these 2 patients were double outlet right ventricle with transposition of the great arteries and complete atrio-ventricular septal defect. Conclusions RT-3DE can clearly display the pathological morphology of complex CHD by a series of novel volumetric views combined with sequential segmental approach through providing more spatial informative cardiovascular structures, which provides a practical method for RT-3DE di展开更多
文摘Background Regional ejection fraction （EFR） measured by real-time three-dimensional echocardiography （RT-3DE） provides a novel method for quantifying left-ventricular （LV） regional systolic function. We aimed to explore the diagnostic value of regional ejection fraction （EFR） derived from RT-3DE in detecting LV aneurysms in patients with myocardial infarction. Methods Thirty-eight patients with myocardial infarction were prospectively enrolled and underwent electrocardiography （ECG）, two-dimensional echocardiography （2-DE）, RT-3DE and left ventriculography （LVG）. Subjects with a negative EFR in at least one segment on RT-3DE were considered as having a ventricular aneurysm. We compared the sensitivity, specificity, Youden＇s index, and positive and negative predictive values of ECG, 2-DE and RT-3DE in determining LV aneurysm with detection by LVG. Results On LVG an LV aneurysm was diagnosed in 16 （42.1%） patients. The sensitivity and specificity were 62.5% and 86.4% for ECG, 81.2% and 95.4% for 2-DE, and 100.0% and 90.9% for RT-3DE in diagnosing LV aneurysm. Youden＇s indexes for ECG, 2-DE and RT-3DE were 0.49, 0.77 and 0.91, respectively. Positive and negative predictive values were 76.9% and 76.0% for ECG, 92.9% and 87.5% for 2-DE, and 88.9% and 100.0% for RT-3DE. Conclusions RT-3DE-derived EFR provides a novel, reliable index in the diagnosis of LV aneurysm and has excellent sensitivity and specificity.
文摘目的 探究三维超声心动图检查对急性心肌梗死(AMI)患者左心室重构和心功能的评估价值。方法 选取2018年2月至2019年2月宝鸡市中医医院收治的AMI且择期接受经皮冠状动脉介入术(PCI)治疗的患者206例,根据患者是否发生左心室重构分为重构组(n=69)和非重构组(n=137)。所有患者入院后48 h内及术后均接受单光子发射计算机断层成像术(SPECT)和三维超声心动图检查,比较两组患者左心室功能参数、三维斑点追踪参数和血清左心室重构指标的差异;采用Pearson相关性分析超声心动图检查与SPECT检查左心室功能参数、三维斑点追踪参数与血清左心室重构指标的相关性。结果 重构组和非重构组患者采用三维超声心动图检查的左室收缩末期容积(LVESV) [(53.27±10.68) mL vs (48.76±9.54) m L]、左室心肌质量(LVM) [(181.54±13.47) g vs(177.46±11.63) g]和左心室质量指数(LVMI) [(135.47±7.23) g/m~2vs (131.54±8.41) g/m~2]比较,重构组明显高于非重构组,左室射血分数(LVEF) [(49.43±6.37)% vs (52.37±7.84)%]、左室整体纵向峰值应变(GLS) [(9.52±1.23) vs (11.87±1.34)]、整体径向峰值应变(GRS) [(29.26±5.56) vs (33.25±6.14)]和整体面积峰值应变(GAS) [(14.21±2.25) vs (18.64±3.18)]比较,重构组明显低于非重构组,差异均有统计学意义(P<0.05);重构组和非重构组患者的血清基质金属蛋白酶 9 (MMP9) [(56.78±9.16) ng/mL vs (48.14±7.45) ng/mL]、成纤维细胞生长因子 23 (FGF23) [(886.47±98.63) pg/mL vs (782.16±95.41) pg/mL]和I型C 端胶原前肽(PICP) [(12.15±2.13) ng/mL vs (9.76±2.21) ng/mL]水平比较,重构组明显高于非重构组,差异均有统计学意义(P<0.05);经Pearson相关性分析结果显示,三维超声心动图检查的LVEDV、LVESV、LVEF指标与SPECT检查结果具有良好的相关性(P<0.01),患者的三维斑点追踪参数GLS、GRS、GAS与血清MMP9、FGF23、PICP水平呈负相关(P<0.05)。结论 三维超声心动图检查可用于�
基金This work was supported by a grant from China Postdoctoral Science Foundation (No. 2004036113).
文摘Background Real-time three-dimensional echocardiography （RT-3DE） has made revolutionized improvements of cardiac imaging during the past few years. However, there is no standard examination method for RT-3DE so far. This study aimed to establish the diagnostic method of RT-3DE and evaluate its application in the diagnosis of complex congenital heart diseases （CHD）. Methods Fifty patients with complex CHD were examined by RT-3DE with modes of Live 3DE and Full Volume. A series of novel volumetric views combined with Van Praagh sequential segmental approach were introduced to reveal the pathological morphology of the hearts, which were compared with the findings of two-dimensional echocardiography （2DE）, angiography and cardiac surgery. Results In 50 patients, 190 image acquisitions of Full Volume were performed at several acoustic windows including subcostal, apical and parasternal regions. Among them, 94.2% （179/190） of image acquisitions were successful. Most sectional volumetric views could be clearly displayed in 92.6% of the successful image acquisitions. However, sectional volumetric views could not be clearly displayed in 7.4%, which was mainly due to poor perspective conditions of examination location, improper instrument multi-parameter setting and insufficient information of whole heart captured in Full Volume acquisitions. As compared with surgical findings and angiography, RT-3DE made correction to the diagnoses in 2 cases including 1 with corrected transposition of the great arteries and the other with single atrium and mitral cleft. The diagnoses initially made by 2DE for these 2 patients were double outlet right ventricle with transposition of the great arteries and complete atrio-ventricular septal defect. Conclusions RT-3DE can clearly display the pathological morphology of complex CHD by a series of novel volumetric views combined with sequential segmental approach through providing more spatial informative cardiovascular structures, which provides a practical method for RT-3DE di
