实时三维超声心动图测定左心室局部射血分数诊断动脉瘤的价值：与左心室造影比较。
Value of left ventricular regional ejection fraction determined by real-time three-dimensional echocardiography in diagnosis of aneurysm: compared with left ventriculography.
机构信息
Department of Cardiology, Affiliated Hospital of Taishan Medical University, Tai'an, Shandong 271000, China.
出版信息
Chin Med J (Engl). 2009 Dec 20;122(24):2981-4.
BACKGROUND
Regional ejection fraction (EF(R)) measured by real-time three-dimensional echocardiography (RT-3DE) provides a novel method for quantifying left-ventricular (LV) regional systolic function. We aimed to explore the diagnostic value of regional ejection fraction (EFR) derived from RT-3DE in detecting LV aneurysms in patients with myocardial infarction.
METHODS
Thirty-eight patients with myocardial infarction were prospectively enrolled and underwent electrocardiography (ECG), two-dimensional echocardiography (2-DE), RT-3DE and left ventriculography (LVG). Subjects with a negative EFR in at least one segment on RT-3DE were considered as having a ventricular aneurysm. We compared the sensitivity, specificity, Youden's index, and positive and negative predictive values of ECG, 2-DE and RT-3DE in determining LV aneurysm with detection by LVG.
RESULTS
On LVG an LV aneurysm was diagnosed in 16 (42.1%) patients. The sensitivity and specificity were 62.5% and 86.4% for ECG, 81.2% and 95.4% for 2-DE, and 100.0% and 90.9% for RT-3DE in diagnosing LV aneurysm. Youden's indexes for ECG, 2-DE and RT-3DE were 0.49, 0.77 and 0.91, respectively. Positive and negative predictive values were 76.9% and 76.0% for ECG, 92.9% and 87.5% for 2-DE, and 88.9% and 100.0% for RT-3DE.
CONCLUSIONS
RT-3DE-derived EFR provides a novel, reliable index in the diagnosis of LV aneurysm and has excellent sensitivity and specificity.
背景
实时三维超声心动图（RT-3DE）测量的局部射血分数（EF（R））为定量左心室（LV）局部收缩功能提供了一种新方法。我们旨在探讨 RT-3DE 衍生的局部射血分数（EFR）在检测心肌梗死后 LV 瘤中的诊断价值。
方法
前瞻性纳入 38 例心肌梗死患者，行心电图（ECG）、二维超声心动图（2-DE）、RT-3DE 和左心室造影（LVG）检查。在 RT-3DE 上至少一个节段出现 EFR 为阴性的患者被认为患有心室瘤。我们比较了 ECG、2-DE 和 RT-3DE 在 LVG 检测中的 LV 瘤诊断的敏感性、特异性、Youden 指数、阳性和阴性预测值。
结果
在 LVG 上诊断出 16 例（42.1%）LV 瘤。ECG、2-DE 和 RT-3DE 诊断 LV 瘤的敏感性和特异性分别为 62.5%和 86.4%、81.2%和 95.4%、100.0%和 90.9%。ECG、2-DE 和 RT-3DE 的 Youden 指数分别为 0.49、0.77 和 0.91。ECG 的阳性和阴性预测值分别为 76.9%和 76.0%、2-DE 的 92.9%和 87.5%、RT-3DE 的 88.9%和 100.0%。
结论
RT-3DE 衍生的 EFR 为 LV 瘤的诊断提供了一种新的、可靠的指标，具有很好的敏感性和特异性。
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