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目的应用实时三维超声与门控心肌灌注显像评价慢性心力衰竭患者CRT术前心功能。方法选择心力衰竭患者58例,其中扩张性心肌病31例、陈旧前壁心梗27例,正常对照组为健康者30例,分别进行实时三维超声心动图(RT-3DE)与门控心肌灌注显像检查(GSPECT MPI)),两种检查间隔1~2d,测定左室整体舒张末期容积(EDV)、左室收缩末期容积(ESV)、射血分数(EF);应用RT-3DE测定心衰患者的局部舒张末期容积(rEDV)、局部左室收缩末期容积(rESV)、局部射血分数(rEF);应用GSPECT MPI评价心衰患者的心肌灌注情况。结果 RT-3DE与GSPECT MPI测定各组患者CRT术前整体心功能相关性良好;RT-3DE可以准确评价心衰患者的局部心功能;GSPECT MPI能够有效地反映心衰患者的心肌灌注情况。结论 RT-3DE与GSPECT MPI在评价心衰患者心功能及心肌灌注情况各有优势,将两者结合对于综合评价心衰患者CRT术前的心功能具有互补作用。
Objective To evaluate the cardiac function before CRT in patients with chronic heart failure by real-time three-dimensional echocardiography and gated myocardial perfusion imaging. Methods Fifty-eight patients with heart failure were selected, including 31 cases of dilated cardiomyopathy, 27 cases of old anterior wall myocardial infarction and 30 cases of normal control group. Real-time three-dimensional echocardiography (RT-3DE) and gated myocardial perfusion (GSPECT MPI)). The left ventricular total end-diastolic volume (EDV), left ventricular end-systolic volume (ESV) and ejection fraction (EF) were measured at 1 ~ (REDV), regional left ventricular end-systolic volume (rESV), and regional ejection fraction (rEF). The myocardial perfusion of patients with heart failure was evaluated by GSPECT MPI. Results RT-3DE and GSPECT MPI showed good overall cardiac function before CRT. RT-3DE could accurately evaluate the local cardiac function in patients with heart failure. GSPECT MPI could effectively reflect myocardial perfusion in patients with heart failure. Conclusion Both RT-3DE and GSPECT MPI have their own advantages in assessing cardiac function and myocardial perfusion in patients with heart failure, and their combination can be used to evaluate the cardiac function before CRT in patients with heart failure.