| Objective: to explore the application value of single-beat real-timethree-dimensional echocardiography（sRT-3DE）on the left ventricular shape,function and16segmental mechanical synchronicity of the heart failurepatients with Dilated cardiomyopathy(DCM). To provide a simple, visual andeffective new method for clinical diagnosis and treat on dilatedcardiomyopathy.Methods: the heart failure group of DCM: the heart failure patients withthe history of DCM, left ventricular enlargement, left ventricular end-diastolicdiameter：male＞55mm and female＞50mm, left ventricular wall thickness isnormal, ventricular wall movement diffuse decreased, left ventricular systolicdysfunction, ejection fraction＜35%, clinical symptoms are consistent withⅢ~Ⅳ of NYHA cardiac function classification. Because the heart failuredegree of the case group was serious, left ventricular end-diastolic diameter inall patients were greater than55mm. In this study30heart failure patientswith Dilated cardiomyopathy were involved from August2011to february2013who have received treatment in our hospital as the research object.21cases were male,9cases were female, aged27-69years, mean age53±10.0years old. There were no cardiac resynchronization therapy, pacemakertherapy, myocarditis, ischemic cardiomyopathy, valvular heart disease,congenital heart disease, poor image quality and not sinus rhythm, all patientswere sinus rhythm.the normal control group:20cases of healthy people were collectedrandomly,10cases were male,10cases were female，aged from28to68years， mean age52±8.3years old, no history of heart disease， electrocardiogram is normal, the age, gender, height, weight, BMI and QRSduration between two groups have no statistically significant difference.Instrument: The SIEMENS ACUSON SC2000ultrasound diagnosticinstrument with single-beat real-time three-dimensional volume imagingsystem,4Z1c full volume probe，frequency2.8MHz, scanning angle90°×90°,volume frame frequency≥12volume per second, synchronouselectrocardiogram. Image processing used TOMTEC imaging system and LVAanslysis software.Image acquisition and indicator: While begins, set the echocardiographicdiagnostic system for left ventricular volume analysis pattern. Let patients totake a left lateral position, connect synchronous electrocardiogram, wait forconsecutive stable QRS complex, put4Z1c probe on the cardiac apical area ofthe chest, get the standard two dimensional4-chamber view, and then, adjustimage to the best articulation, press4D key to start real-timethree-dimensional volume scanning. After acquired a standard, clear andstable volume image of left ventricle, freeze image, save a single cardiac cycleof dynamic three-dimensional image. Every patient save three volume imagefor software analysis. Start the LVA software, apply it to analyse achievedimages, endocardial border were automatic identifed, calculates LVEDV,LVESV, LVEF, ESSI, EDSI, SDI, DDI, DISPES and DISPED, all the data hasbeen corrected by the heart rate. Express the data with the percentage of thecardiac cycle. At the same time, the ensemble left ventricular time-volumecurve and16segments time-volume curve of left ventricle were displayed.Statistic analysis: measurement data expressed with mean±standarddeviation. the case group and the normal control group compared with meandifferences by t test of independent-samples. The relevant comparison to dolinear correlation analysis, it was a statistical significance when P＜0.05.Result:1Compared with normal control group, the reduce of LVEF hadstatistically significant（P＜0.01）in the heart failure group of DCM;2Compared with normal control group, the enlargement of ESSI and EDSI had statistically significan（tP＜0.01）in the heart failure group of DCM;3Between the heart failure group of DCM and the normal control group,the16segment SDI and DDI of left ventricle were significant different(P＜0.01). The16segments time-volume curve of left ventricle of the case groupwere disordered, on the contrary, the curve of the normal control group weresmooth and ordered.4Compared with the normal control group, the enlargement of DISPESand DISPED had statistically significant（P＜0.01）in the heart failure groupof DCM;5LVEF was negative correlated with the16segment SDI of leftventricle(r=-0.693，P＜0.01).Conclusion:1In the heart failure group of DCM, left ventricular systolic function waslower than the normal population；2the shape of left ventricle of the heart failure group of DCM wasapproximate to sphere.3The16segment diastolic and systolic synchronicity of left ventricle ofthe heart failure group of DCM were poor than normal population.4The16segment end-diastolic and end-systolic dispersion wereenlarged than normal population;5There was relevance between LVEF and the16segment SDI of leftventricle in the heart failure group of DCM;6sRT-3DE is a simple, visual and effective new method for clinical toevaluate left ventricular function and mechanical dyssynchrony of the heartfailure patients of DCM. |
PDF Full Text Request