| Background: The prognosis of myocardial infarction patients has close relationship with the left ventricular systolic function which relies on segmental wall movement and the synchrony of them. In normal condition, synchrony of myocardial contraction and relaxation is very important for sufficient myocardial blood supply. Myocardial infarction can lead to the decrease of the systolic function and synchrony. Thereby, quantitative analysis of myocardial infarction region and ischemic region is vital for diagnosis and treatment of myocardial infarction.Objective:1. To explore the differences of the volume and systolic function between patients with myocardial infraction and normal people using two-dimensional echocardiography (2DE) and real-time three-dimensional echocardiography (RT-3DE).2. To explore the feasibility and accuracy of using RT-3DE in evaluation of the volume and left ventricular systolic function in patients with myocardial infarction.3. To explore the feasibility and accuracy of using RT-3DE in evaluation of the left ventricular synchrony in patients with myocardial infarction and normal people. Methods: 2DE and RT-3DE were performed on 18 patients with myocardial infarction (the myocardial infarction group) and 16 normal subjects (the control group). Left ventricular end-diastolic volume (LVEDV), Left ventricular end-systolic volume (LVESV), Left ventricular ejection fraction (LVEF), the globe and regional Volume-time curves (VTCs), the standard deviation (SD) of the time to the point with minimal systolic volume (Tmsv) in 16 segments, the SD of Tmsv in 12 segments, the SD of Tmsv in 6 segments, the difference (Dif) of the time to Tmsv in 16 segments, the Dif of Tmsv in 12 segments and the Dif of Tmsv in 12 segments were determined by RT-3DE and QLAB software. The SD of Tmsv in 16,12,6 segments and the Dif of the Tmsv in 16, 12, 6 segments were adjusted by the R-R interval by QLAB software. They were as follows: TmsvSD-16%,TmsvSD-12%,TmsvSD-6%,Tmsv-16Dif%,Tmsv-12Dif%,Tmsv-6Dif% . LVEDV, LVESV and LVEF were obtained by 2DE.Results:1. Compared with the control group, LVEF of myocardial infarction group decreased (P < 0.05), while LVEDV and LVESV increased both by using RT-3DE and 2DE (P < 0.05).2. LVEDV, LVESV and LVEF of the control group obtained by RT-3DE has close correlation with those obtained by 2DE (r = 0.957, 0.973 and 0.912, P < 0.05), LVEDV, LVESV and LVEF of myocardial infarction group obtained by RT-3DE has lower but also close correlation with those obtained by 2DE (r=0.840, 0.919 and 0.791, P< 0.05).3. LVEDV and LVESV obtained by RT-3DE were higher than those obtained by 2DE( P < 0.05), while LVEF by RT-3DE was lower than that by 2DE( P < 0.05).4. VTCs of the control group were in order and steep, just like inverse parabola while the VTCs of the myocardial infarction group were out of order and mild. The time to the point with minimal systolic volume in each segment of the control group were centered while those of the myocardial groups were not.5. LVEF obtained by RT-3DE of myocardial group has inverse correlation with TmsvSD-16%, Tmsv-16Dif%, TmsvSD-16% and Tmsv-16Dif% (r=-0.712, -0.690, -0.720 and -0.716, P < 0.05).6. Compared with the control group, TmsvSD-16,TmsvSD-12,TmsvSD-6,Tmsv-16Dif,Tmsv-12Dif,Tmsv-6Dif,TmsvSD-16%,TmsvSD-12%,TmsvSD-6%, Tmsv-16Dif%,Tmsv-12Dif%,Tmsv-6Dif% of myocardial infarction group were higher, and TmsvSD-16,TmsvSD-16%,Tmsv-16Dif and Tmsv-16Dif% between the two groups has significant difference (P < 0.05).Conclusion:1. Both 2DE and RT-3DE could accurately evaluate left ventricular volume and systolic function in normal people.2. RT-3DE could more accurately evaluate left ventricular volume and systolic function in myocardial infraction patients than 2DE.3. RT-3DE can objectively evaluate left ventricular systolic synchrony in patients with myocardial infarction.4. TmsvSD-16% and Tmsv-16Dif% may be potential parameters to evaluate systolic synchrony.
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