三维超声心动图评价心脏再同步化治疗术后即刻左心室同步性改变

发布时间：2018-04-19 15:59

本文选题：三维超声心动图 + 心脏再同步化治疗　；参考：《中国超声医学杂志》2015年01期

【摘要】：目的探讨实时三维超声心动图(RT-3DE)评估心脏再同步化治疗(CRT)后即刻左心室同步性改变的价值。方法选择慢性心力衰竭拟行CRT患者62例,采用RT-3DE评价CRT术前以及术后即刻左心室16节段收缩末期容积达峰时间标准差(Tmsv16-SD),计算术前以及术后6个月左心室舒张末期容积变化率(ΔLVEDV)、左心室收缩末期容积变化率(ΔLVESV)以及左心室射血分数变化率(ΔLVEF),筛选预测CRT反应的最佳Tmsv16-SD截断值。结果ΔTmsv16-SD与ΔLVEDV(r=0.563,P0.001)、ΔLVESV(r=0.612,P0.001)以及ΔLVEF(r=0.442,P0.001)呈线性正相关;以ΔTmsv16-SD=5.4%为截断值,预测CRT反应的ROC曲线下面积为0.857(95%CI:0.760~0.953),灵敏度为85.0%、特异度为86.4%。结论慢性心力衰竭CRT术后即刻左心室同步性改善可以显著改善CRT疗效,ΔTmsv16-SD可能是预测CRT反应的新的有效指标。
[Abstract]:Objective to evaluate the value of real-time three-dimensional echocardiography (RT-3DE) in assessing immediate left ventricular synchrony changes after cardiac resynchronization therapy (CRT). Methods 62 patients with chronic heart failure were selected for CRT, and RT-3DE was used to evaluate the standard deviation (Tmsv16-SD) before and after CRT (Tmsv16-SD) at the end systolic volume of the left ventricle. The rate of left ventricular end diastolic volume change (delta LVEDV), left ventricular end systolic volume change rate (delta LVESV) and left ventricular ejection fraction (delta LVEF) were used to screen the best Tmsv16-SD truncation values for predicting CRT reaction. The results were Delta Tmsv16-SD and delta LVEDV (r= 0.563, P0.001), Delta LVESV (r=0.612, P0.001) and delta LVEDV 01) linear positive correlation, with a truncated value of delta Tmsv16-SD=5.4%, the area under the ROC curve for predicting CRT reaction is 0.857 (95%CI:0.760~0.953) and the sensitivity is 85%. The specificity is 86.4%. conclusion that the immediate improvement of left ventricular synchrony after chronic heart failure after CRT can significantly improve the effect of CRT therapy, and Delta Tmsv16-SD may be a new effective index for predicting the CRT response. Standard.

【作者单位】：解放军第四军医大学西京医院超声科;解放军第四军医大学西京医院心脏内科;
【基金】：国家自然科学基金项目(No.81170305) 陕西省社发攻关项目(No.2012k15-02-03) 全军后勤科研计划项目(No.CWSIIJ056)
【分类号】：R540.45

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