Assessment Of The Left Ventricular Function And Diastolic Synchrony Of Cardiac Resynchronization Therapy Via Real Time Three-dimensional Echocardiographic Volume-time Curves

Objective:To evaluate the diastolic function and relationship between diastolic function andearly diastolic synchrony in patients with dilated cardiomyopathy (DCM) by realtime three-dimensional echocardiography (RT-3DE) volume-time curves (VTC)after cardiac resynchronization therapy（CRT）；to compare with LBBB and NLBBBeffect after CRT.Methods:.Thirty-nine patients with DCM were enrolled by RT-3DE VTC before and1week,6months,12months after CRT, draw the left ventricular (LV)6,12,16segments LV diastolic early volume standard deviation of the time (Tedv-SD), andwith the R-R interval normalized as early diastolic unsynchronized index (DDI); drawend-systolic volume (LVESV), LV end-diastolic volume (LVEDV), LV ejectionfraction (LVEF); and calculate the diastolic peak filling rate (PFR)、early diastolicvolume and end-diastolic volume ratio (EDV early/EDV):In addition,39patientswere divided into two subgroups of LBBB group (25cases) and NLBBB group (14cases), compare the CRT after12months of LVEF, LVEDV, DDI, and the pre andpostoperative differenceΔLVEF,ΔLVEDV,ΔDDI.Results:①LVEDV、LVESV had no significant improvement, compared with the beforeand1week after CRT,but the improvement was statistically significant after6months and12months (P <0.05, P <0.01); LVEF after1week,6months and12months were statistically significant (P<0.05);②PFR was significantly increased after6months (P <0.05), EDV early/EDV%at12months after CRT was significantly reduced (P <0.01); There was asignificantly shortened in each segment (Tedv-SD)/R-R1week after CRT (P <0.01), but the parameters had no obvious improvement later.③Correlation analysis: Δ DDI and Δ EDV早/EDV reduction was significant positive correlation (r=0.52, P <0.01), Δ DDI and ΔPFR has negative correlation (r=-0.40, P <0.05), Δ EDV early/EDV%with ΔPFR also had a good relationship (r=-0.56, P <0.01).④Compared with NLBBB group, the LBBB group LVEF had statisticalsignificance after CRT(P<0.0001); LVEDV was significantly reduced (P=0.020);DDI improved significantly (P=0.036);Δ LVEF, Δ LVEDV, Δ DDI were significantdifference in the two groups (P<0.01).Conclusions:①The LV synchrony and diastolic function were improved after CRT in patientswith DCM; PFR、EDV early/EDV can be used as evaluation of left ventriculardiastolic function effectively targets.②Early diastolic synchronization improvements will continue to improve leftventricular diastolic function.③The LBBB benefit is superior to the NLBBB after CRT in patients withDCM.④RT-3DE VTC can visually display myocardial motion amplitude andsynchronization, and to evaluate the efficacy before and after CRT in patients withDCM...