Real-time Three-dimensional Echocardiography In Evaluation On Left And Right Ventricular Systolic Function In Patients With Alcoholic Cardiomyopathy

Objective: To evaluate the left and right ventricular systolic function in patientswith alcoholic cardiomyopathy (ACM) by real-time three-dimensionalechocardiography (RT-3DE).Methods: We enrolled30male alcoholics who were examined at the secondaffiliated hospital of dalian medical university from February2010to November2012.Entry criteria including: consume≥150mg ethanol or≥2000ml beers daily for morethan10years, and exclusion criteria included a history of hypertension, diabetes,coronary heart disease, rhythm problems, heart value disease, use of cardiacmedications, or other systemic diseases that could affect the cardiac structure andfunctions. The control group of30healthy men volunteer who did not exhibit anycardiovascular abnormalities was recruited from subjects attending health bodyexamination in our hospital. Totally30patients with alcoholic cardiomyopathy (ACMgroup) and30normal subjects (control group) underwent conventionalechocardiography and RT-3DE respectively.1. The parameters of left ventricular: left ventricular end-diastolic volume(LVEDV), left ventricular end-systolic volume (LVESV), left ventricular ejectionfraction (LVEF), left ventricular mass(LVM) and left ventricular mass index (LVMI)were measured with conventional echocardiography and RT-3DE respectively, at the same time, the left ventricular capacity-time curve was acquired by RT-3DE, and theparameters of Tmsv16-SD, Tmsv16-Dif, Tmsv16-SD/R-R(%) and Tmsv16-Dif/R-R(%)were calculated. Above parameters were compared statistically between ACM andcontrol group, and then compared parameters of RT-3DE with2DE.2. The parameter of right ventricular: right ventricular end-diastolic area (RVEDA)and end-systolic area (RVESA) were measured with two-dimensional echocardiography(2DE), and the right ventricular fractional area change (RVFAC) was then calculated.Three tricuspid annular systolic displacement (TAPSE) was measured by using M-modeechocardiography. Right ventricular end-diastolic volume (RVEDV), end-systolicvolume (RVESV), stroke volume (RVSV) and ejection fraction (RVEF) were measuredwith RT-3DE. Above parameters were compared between ACM and control group, andthe correlations of RVFAC, TAPSE and RVEF were analyzed.Results:1. The results of parameters of left ventricular:Conventional echocardiography: LVEDV, LVESV, LVM and LVMI measured inACM group were higher than those in control group (all P<0.05), and LVEF in ACMgroup was lower than that in control group (all P<0.05).RT-3DE: LVEDV, LVESV, LVM and LVMI in ACM group were higher than thosein control group (all P<0.05), and LVEF in ACM group was lower than that in controlgroup (all P<0.05); Tmsv16-SD, Tmsv16-Dif, Tmsv16-SD/R-R(%) andTmsv16-Dif/R-R(%) in ACM group were higher than those in control group (allP<0.05).Compared RT-3DE with2DE: LVEDV, LVESV, LVEF, LVM and LVMI in controlgroup had no significant difference (all P>0.05); LVEDV, LVESV, LVM and LVMI inACM group had significant difference (all P<0.05), but LVEF in ACM group had nosignificant difference (all P>0.05).2. The results of parameters of right ventricular:Conventional echocardiography: RVEDA and RVESA in ACM group were higherthan those in control group (all P<0.05); LVEF, RVFAC and TAPSE in ACM group were lower than those in control group (all P<0.05).RT-3DE: RVEDV and RVESV were higher in ACM group than those in controlgroup (all P<0.05), and RVEF was lower in ACM group than those in control group (allP<0.05), while there was no significant difference in RVSV between two groups(P>0.05).RVFAC and TAPSE were positively correlated with RVEF (r=0.610and0.822, allP<0.05).Conclusion:1. RT-3DE is able to reflect left ventricular systolic disfunction and asynchrony inalcoholic cardiomyopathy, and provide a reliable basis for clinical diagnosis.2. RT-3DE can accurately assess right ventricular systolic function in alcoholiccardiomyopathy, which is valuable on clinical application.