Assesment Of Global And Regional Systolic Function Of Left Ventricular In Patients With Coronary Artery Disease After Treatment By Volume-time Curves Of Real-time Three-dimensional Echocardiography Therapy

Objective:To assess global and regional systolic function of left ventricularin patients with coronary artery disease(CAD) after percutaneous coronaryintervention(PCI) by volume-time curves(VTC) of real-timethree-dimensional echocardiography（RT-3DE）.Methods:45patients with CAD enrolled in this study were divided into twogroups.Group A consisted of22patients with myocardial ischemia, GroupB included23patients with myocardial infarction.20healthy volunteersas the normal control group. All participants were were examined bytwo--dimensional echocardiography(2DE) and full volume RT-3DE. Allpatients with CAD were examined before PCI,1week and3months after PCIrespectively. The global left ventricular systolic function and17-segmental VTC were obtained by the off-line Qlab software. The regionalejection fractions(REF)and regional-global ejection fractions(RGEF)were calculted.Results:1.Compared with normal subjects, The LVDd and LVEDV and LVESV of groupB befor PCI were increased, and LVEF decreasedsignificantly(P<0.05).There were no significant difference between groupA and normal subjects.2.Compared with normal subjects, global left ventricular function measured by3DE in patients with CAD before PCI had significantlydifference(P<0.05).LVEDV and LVESV were increased, LVEF wasdecreased.LVEDV and LVESV and LVEF measured by3DE and2DE had nosignificantly difference in normal subjects,while effectiv statisticchanges were found in group A and B.3.Three dimensional distribution of the regional left ventricularsystolic function in normal subjects were not uniform.The REF wasdecreasing from apex to base,while the RGEF was contrary to.4.Compared with normal subjects, REF and RGEF in segments withinfarction decreased significantly (P<0.05).5.Compared with group A befor PCI, LVEF and REF and RGEF improved afterPCI1week（P<0.05）,and some improvement after PCI3months.There wereno significant improvement in group B before and after PCI1week（P>0.05）.REF and RGEF improved in some segments. LVEF of group B increasedsignificantly after PCI3months（P<0.05）,and REF、RGEF improved in themost segments of infarction.Conclusions:1. The quantitation of global volume and heart function of LV werecalculated exactly on RT-3DE than2DE．RT-3DE can display real-timethree-dimensional structure of the heart. The accurate information forthe diagnosis of CAD was provided by RT-3DE．2.Volume-time curves and REF and RGEF measured by RT-3DE can assessthe left ventricular volumn and segments function.3.Global and regional systolic function of left ventricular ofmyocardial infarction group were lower than those at normal subjects andmyocardial ischemia group. After coronary artery recanalization,leftventricular function were improved in both myocardial infarction groupand myocardial ischemia group,but the latter improved more obvious in theshort-term after PCI 4.PCI can improve the global and the regional systolic function ofLV．Volume-time curves of RT-3DE was a useful method for evaluating thecurative effect of CAD.