应用实时三维超声心动图评价冠心病三支病变患者冠状动脉旁路移植术前后左室重构及心功能变化

摘要

Objective To investigate the value of Real-time Three-dimensional Echocardiography (RT-3DE) to estimate left ventricular remodeling and the change of heart function in patients with three coronary arteries disease before and after coronary artery bypass graft(CABG). Methods Data of normal control (group A), three coronary arteries disease(group B) and three coronary arteries disease with left ventricular aneurysm (group C) were acquired using RT-3DE befor and after CABG. The left ventricular global and regional end diastolic volume(EDV) ,end systolic volume(ESV) , ejection fraction(EF) , global peak rapid filling rate(gPRFR) and ejection rate (gPER) were obtained. Results Before CABG, heart function of Group B and C was significantly lower than that of group A. There was no significant improvement in group B and C one month after CABG. Heart function after three months were better than that before CABG and after one mongth(P<0. 05). Heart function significantly raised after six months (P<0. 01), Group B was better than Group C. There was no significant difference after one year and six months. Group B approached the normal level after six months. Group C was lower than Group B and Group A(P<0. 05). Conclusions Cardiac function of patients with three coronary arteries disease gradually became better after CABG. RT-3DE could quantitatively evaluate left ventricular remodeling , the change of global and regional heart function befor and after CABG in different time.%目的 应用实时三维超声心动图(RT-3DE)等评价冠心病3支病变患者冠状动脉旁路移植术(CABG)前后左室重构及心功能变化的价值.方法 对照组(A组)20例、冠心病3支病变组(B组)30例及冠心病3支病变合并室壁瘤组(C组)10例,术前及术后应用RT-3DE测得左室整体及局部舒张末期容积(EDV)、收缩末期容积(ESV)、射血分数(EF)、整体峰值快速充盈率(gPRFR)及峰值射血率(gPER).结果 术前B组和C组与A组比较心功能明显减低.术后1个月B、C两组心功能改善不明显.术后3个月较术前及术后1个月有所改善(P＜0.05).术后6个月心功能明显改善(P＜0.01),B组改善优于C组.术后1年与6个月比较无统计学意义,B组术后6个月心功能接近正常水平,C组术后6个月整体及局部心功能均较B组和A组减低(P＜0.05).结论 CABG术可有效逆转冠心病3支病变患者的左室重构,改善心功能.RT-3DE可定量评价CABG术前后左室整体及局部心功能的变化.