【摘要】 目的探讨实时三维超声心动图(RT-3DE)对经皮左室重建术(PVR)后心脏形态及功能评价的应用价值。方法选取我院行PVR的陈旧性前壁心肌梗死合并室壁瘤患者7例,应用RT-3DE评估患者术前及术后6个月左室形态变化、收缩功能及同步性;测量R-R间期校正的左室16、12节段达到最小收缩容积时间的标准差和最大差(Tmsv16-SD%、Tmsv16-Dif%、Tmsv12-SD%、Tmsv12-Dif%)。结果 7例患者术后6个月NYHA心功能分级较术前明显下降,6 min步行试验较术前明显增加(均P<0.01);三维左室形态均明显改善,心尖部室壁瘤被有效隔离。术后RT-3DE测得左室收缩功能指标(3D-EF、3D-EDV及3D-ESV)均得到明显改善(均P<0.05);Tmsv16-SD%、Tmsv16-Dif%均较术前明显缩短(均P<0.05)。结论 PVR是一种安全有效的微创介入治疗室壁瘤方法;RT-3DE可以准确评价PVR术后心脏形态、左室收缩功能及同步性。更多还原

【Abstract】 Objective To assess the application value of real-time three-dimensional echocardiography(RT-3DE)in evaluating left ventricular(LV)systolic function in patients with percutaneous ventricular restoration(PVR). Methods Seven patients with anterior wall myocardial infarction complicated with apical aneurysm were enrolled for PVR. The changes in LV morphology,LV systolic function and systolic synchrony were observed by RT-3DE. before and 6 months after the operation. The standard deviation(SD)and difference(Dif)of the time to the point with minimal systolic volume(Tmsv)in 16 and 12 segments adjusted by the R-R interval(Tmsv16-SD%,Tmsv16-Dif%,Tmsv12-SD%,Tmsv12-Dif%)were measured. Results Six months after the operation,post-procedure NYHA class reduced and six-minute walk test increased evidently compared to pre-procedure(all P<0.01). LV apical geometry recovered and LV systolic function(3D-EF,3D-EDV and 3D-ESV)improved significantly after PVR(all P<0.05). The index of LV systolic synchrony(Tmsv16-SD% and Tmsv16-Dif%)were reduced markedly compared to pre-procedure(both P<0.05). Conclusion PVR is a relatively safe and effective technology for apical aneurysm therapy. RT-3DE can accurately evaluate the heart shape,LV systolic function and systolic synchrony after PVR.更多还原