用电子束断层扫描评估部分左心室切除术对左、右心室容积和功能的影响：初步结果
Effect of partial left ventriculectomy on left and right ventricular volumes and function as assessed with electron beam tomography: preliminary results.
作者信息
Enzweiler Christian N H, Wiese Till H, Lembcke Alexander E, Hotz Holger, Kivelitz Dietmar E, Baerisch Anne, Taupitz Matthias, Borges Adrian C, Baumann Gert, Konertz Wolfgang, Hamm Bernd
机构信息
Department of Radiology, Charité, Humboldt-Universität zu Berlin, Schumannstrasse 20/21, 10098 Berlin, Germany.
出版信息
Eur Radiol. 2003 Jun;13(6):1394-401. doi: 10.1007/s00330-002-1653-2. Epub 2002 Oct 15.
Our objective was to determine if left ventricular reduction surgery affects left and right ventricular volumes and function. Twenty-three patients with end-stage heart failure underwent contrast-enhanced electron beam tomographic function studies before and twice after partial left ventriculectomy (PLV). The PLV was combined with other cardiosurgical procedures in 20 of 23 patients. Left and right ventricular enddiastolic volume (LVEDV, RVEDV), stroke volume (LVSV, RVSV), ejection fraction (LVEF, RVEF), and enddiastolic diameter (LVEDD, RVEDD) were determined by manual tracing of endo- and epicardial borders at enddiastole and endsystole. Patients were scanned 31 days (+/-34) before and 18 days (+/-13) and 8 months (+/-4) after PLV. Mean pre- and early and late postoperative values for LVEDV, LVSV, LVEF, and LVEDD were 387.9 ml (+/-125.5 ml), 255.6 ml (+/-79.3 ml; p<0.01), and 253.7 ml (+/-97.8 ml; p<0.05), 79.7 ml (+/-25.2 ml), 74.8 ml (+/-17.9; n.s.), and 79.1 ml (+/-26.5 ml; n.s.), 21.6% (+/-7.3%), 31.9% (+/-13.4%; p<0.05), and 34.1% (+/-14.1%; p<0.05), and 72.0 mm (+/-10.6 mm), 64.3 mm (+/-8.5 mm; p<0.05), and 63.5 mm (+/-9.4 mm; p<0.05), respectively. Mean pre- and postoperative values for RVEDV, RVSV, RVEF, and RVEDD were 177.7 ml (+/-72.8 ml), 172.4 ml (+/-59.2 ml; n.s.), and 178.9 ml (+/-60.8 ml; n.s.), 60.3 ml (+/-21.6 ml), 68.8 ml (+/-19.9 ml; n.s.), and 78.3 ml (+/-25.3 ml; n.s.), 38.1% (+/-15.4%), 43.7% (+/-16.3%; p<0.05), and 45.1% (+/-11.2%; n.s.), and 50.4 mm (+/-10.9 mm), 48.1 mm (+/-8.7 mm; n.s.), and 48.5 mm (+/-9.8 mm; n.s.), respectively. The PLV may induce a significant early reduction of left ventricular volumes and improvement of biventricular function; however, our results must be judged carefully as the majority of patients in this study underwent additional cardiosurgical procedures, the contributory effect of which on the overall outcome remains unclear.
我们的目的是确定左心室减容手术是否会影响左、右心室容积及功能。23例终末期心力衰竭患者在部分左心室切除术（PLV）前及术后两次接受了对比增强电子束断层扫描功能研究。23例患者中有20例的PLV与其他心脏外科手术联合进行。通过在舒张末期和收缩末期手动描绘心内膜和心外膜边界来测定左、右心室舒张末期容积（LVEDV、RVEDV）、每搏输出量（LVSV、RVSV）、射血分数（LVEF、RVEF）以及舒张末期直径（LVEDD、RVEDD）。患者在PLV前31天（±34天）、术后18天（±13天）和8个月（±4个月）接受扫描。LVEDV、LVSV、LVEF和LVEDD的术前、术后早期及晚期平均数值分别为387.9毫升（±125.5毫升）、255.6毫升（±79.3毫升；p<0.01）和253.7毫升（±97.8毫升；p<0.05），79.7毫升（±25.2毫升）、74.8毫升（±17.9毫升；无显著差异）和79.1毫升（±26.5毫升；无显著差异），21.6%（±7.3%）、31.9%（±13.4%；p<0.05）和34.1%（±14.1%；p<0.05），以及72.0毫米（±10.6毫米）、64.3毫米（±8.5毫米；p<0.05）和63.5毫米（±9.4毫米；p<0.05）。RVEDV、RVSV、RVEF和RVEDD的术前、术后平均数值分别为177.7毫升（±72.8毫升）、172.4毫升（±59.2毫升；无显著差异）和178.9毫升（±60.8毫升；无显著差异），60.3毫升（±21.6毫升）、68.8毫升（±19.9毫升；无显著差异）和78.3毫升（±25.3毫升；无显著差异），38.1%（±15.4%）、43.7%（±16.3%；p<0.05）和45.1%（±11.2%；无显著差异），以及50.4毫米（±10.9毫米）、48.1毫米（±8.7毫米；无显著差异）和48.5毫米（±9.8毫米；无显著差异）。PLV可能会导致左心室容积在早期显著减小，并改善双心室功能；然而，由于本研究中的大多数患者还接受了其他心脏外科手术，其对总体结果的贡献作用仍不明确，因此我们的研究结果必须谨慎判断。
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