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目的 :应用单心动周期实时三维超声心动图(single beat real-time three-dimensional echocardiography,sRT-3DE)评价扩张型心肌病(dilated cardiomyopathy,DCM)患者左、右心室的收缩功能及左心室收缩同步性。方法:对17例DCM患者和17名年龄性别相匹配的健康对照者行s RT-3DE检查,通过专有软件分析获得以下参数。(1)左心室常规容积参数,包括左心室舒张末期和收缩末期的容积、左心室每搏输出量和射血分数(ejection fraction,EF);(2)左心室几何形态学参数,包括收缩末和舒张末的球形指数;(3)左心室收缩期节段容积变化同步性参数,包括收缩期失同步指数(systolic dyssynchrony index,SDI)、收缩末离散差、收缩后和收缩前的时间容积及平均收缩时间;(4)右心室容积参数,包括右心室舒张末期和收缩末期容积、右心室每搏输出量和EF。各项容积参数按照体表面积进行标化。结果:与对照组相比,DCM组标化的左、右心室舒张末期和收缩末期容积均增大,左、右心室EF均减小(P均<0.01);左心室舒张末和收缩末的球形指数均增大(P均<0.01);SDI、收缩末离散差、收缩前及收缩后时间容积均增大(P均<0.01)。采用sRT-3DE检查评价左、右心室收缩功能和左心室同步性平均费时仅需5 min。结论:sRT-3DE能够揭示DCM患者左、右心室的收缩功能及左心室同步性异常,且检查费时少,或可常规应用于DCM患者的心功能评估及随访。
Objective: To evaluate the systolic function and systolic left ventricular systolic function in patients with dilated cardiomyopathy (DCM) by single beat real-time three-dimensional echocardiography (sRT-3DE) Sex. Methods: RT-3DE was performed on 17 DCM patients and 17 age-matched healthy controls. The following parameters were obtained by proprietary software analysis. (1) Left ventricular conventional volumetric parameters, including left ventricular end-diastolic volume and end-systolic volume, left ventricular stroke volume and ejection fraction (EF); (2) Left ventricular geometry parameters including end-systolic And end-diastolic spherical index. (3) Synchronic parameters of left ventricular systolic volume change, including systolic dyssynchrony index (SDI), end-systolic dispersion, time after systole and before systole and (4) right ventricular volume parameters, including right ventricular end-diastolic and end-systolic volume, right ventricular stroke volume and EF. The volume of the parameters in accordance with the body surface area of the standardization. Results: Compared with the control group, the left and right ventricular end-diastolic and end-systolic volumes in the DCM group increased, while the left and right ventricular EF decreased (all P <0.01); left ventricular end-diastolic and end-systolic Spherical index increased (P <0.01); SDI, end-systolic dispersion difference, systolic and contractile time volume increased (P <0.01). Evaluation of left and right ventricular systolic function and left ventricular synchrony using the sRT-3DE test averaged only 5 min. Conclusion: sRT-3DE can reveal the left and right ventricular systolic and left ventricular synchrony abnormalities in patients with DCM, and the time-consuming examination can be routinely applied to DCM patients with cardiac function assessment and follow-up.