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实时三维超声心动图对心脏再同步化治疗心衰患者的疗效评价
Assessment of Therapeutic Response to Cardiac Resynchronization Therapy in Patients with Heart Failure by Real-time Three-dimentional Echocardiography
【摘要】 目的应用实时三维超声心动图技术(RT-3DE)评价心脏再同步化治疗(CRT)心衰的疗效。方法选取15例经RT-3DE评价为左室收缩不同步接受CRT的心衰患者,分别于术后1周内,3个月时给予经胸实时三维超卢心动图检查,应用Qlab定量分析软件,获取并分析左室整体功能参数,以及不同步指数,即心率校正后的16节段收缩达最小容积标准差(Tmsv16-sd/RR/),对上述三维参数进行定量分析比较。结果术后1周内左室整体功能参数较术前无明显改善(P>0.05),而左室不同步指数Tmsv16-sd/RR较术前明显降低,差别有统计学意义(P<0.001)。3个月时左室整体功能参数及左室不同步指数均较术前有明显改善(P<0.01),但左室不同步指数Tmsv16-sd/RR术后3个月与术后1周内相比差别无统计学意义(P>0.05)。结论 CRT可降低左室不同步指数,从而改善左室功能,不同步指数Tmsv16-sd/RR能够较早且敏感地预示该变化。
【Abstract】 Objective To assess the therapeutic response to cardiac resynchronization therapy ( CRT ) in patients with heart failure (HF) hy real-time three-dimensional echocardiography (RT-3DE) . Methods Fifteen HF patients defined as left ventricular dyssynchrony with RT-3DE evidence undergoing CRT were enrolled. All the patients underwent transthoracic RT-3DE examination within 1 week, 3-month follow-up after CRT implantation, respectively. Parameters of left ventricular global function and left ventricular dyssynchrony index of RT-aDE, which were defined as the time to minimum systolic volume of 16-segmental standard deviation as a ratio of R-R interval (Tmsv16sd /RR ), were obtained and analyzed by the on-line Qlab software. All the 3D parameters were compared with those before CRT, respectively. Results Within 1 week after CRT, parameters of left ventricular global function had no significant improvement (P>0.05), but the left ventricular dyssynchrony index Tmsv16-sd/RR reduced significantly (P<0. 001) compared with those before CRT. At the 3-month follow-up, the left ventricular global function and the left ventricular dyssynchrony index were all improved significantly compared with those before CRT. But the left ventricular dyssynchrony index Tmsv16-sd /RR showed no further reduction compared with those within 1 week after CRT (P>0.05) . Conclusions CRT can reduce the left ventricular dyssynchrony index and improve left ventricular function. Tmsv16-sd /RR can predict this change acutely and sensitively.
【Key words】 Cardiac resynehronizayion therapy; Heart failure; Echoeardiography; Real-time three-dimentional; Dyssynchrony;
- 【文献出处】 中国超声医学杂志 ,Chinese Journalof Ultrasound in Medicing , 编辑部邮箱 ,2010年05期
- 【分类号】R540.45;R541.6
- 【被引频次】11
- 【下载频次】34