Jennesseaux C, Metz D, Maillier B, Nazeyrollas P, Maes D, Tassan S, Chabert J P, Elaerts J
Service de cardiologie, CHU Robert-Debré, Reims.
Arch Mal Coeur Vaiss. 1996 Jul;89(7):843-9.
The object of this study was to assess the reliability of measurements of left ventricular volumes and ejection fraction by acoustic quantification by the method of summation of discs in acute myocardial infarction. Thirty-two patients with an average age of 55.9 +/- 12 years were studied prospectively on average 6 +/- 2 days after the onset of myocardial infarction. Within 48 hours, the patients underwent TM echocardiography (Teichholz's method) two-dimensional echocardiography (Simpson's method on freeze frames and acoustic quantification) before left ventricular angiography and isotopic ventriculography, considered as the reference methods for comparing left ventricular volumes and ejection fractions. The data displayed in real time by acoustic quantification correlated well with the results of left ventricular angiography (r = 0.77; p = 0.0001) and moderately underestimated (+4.1 +/- 11.9%) the ejection fraction, but were relatively disappointing for estimating volumes. When compared with isotopic ejection fraction, the correlation coefficient was r = 0.71 (p = 0.0004) and the values were overestimated. In this study, acoustic quantification was the most reliable echocardiographic method of assessing the left ventricular ejection fraction with reference to contrast angiography (Teichholz: r = 0.56; p = 0.0014; Simpson: r = 0.76; p = 0.001). The authors conclude that assessing the left ventricular ejection fraction with acoustic quantification is reliable in acute myocardial infarction. However, the method is not very accurate in measuring end systolic and end diastolic volumes.
本研究的目的是通过在急性心肌梗死中采用圆盘求和法的声学定量技术,评估左心室容积和射血分数测量的可靠性。对平均年龄为55.9±12岁的32例患者进行了前瞻性研究,平均在心肌梗死发病后6±2天进行。在48小时内,患者在左心室造影和同位素心室造影之前接受了TM超声心动图检查(Teichholz法)、二维超声心动图检查(对冻结帧采用Simpson法和声学定量),左心室造影和同位素心室造影被视为用于比较左心室容积和射血分数的参考方法。通过声学定量实时显示的数据与左心室造影结果具有良好的相关性(r = 0.77;p = 0.0001),并且对射血分数有中度低估(+4.1±11.9%),但在估计容积方面相对令人失望。与同位素射血分数相比,相关系数为r = 0.71(p = 0.0004),且数值被高估。在本研究中,参照对比造影(Teichholz:r = 0.56;p = 0.0014;Simpson:r = 0.76;p = 0.001),声学定量是评估左心室射血分数最可靠的超声心动图方法。作者得出结论,在急性心肌梗死中,用声学定量评估左心室射血分数是可靠的。然而,该方法在测量收缩末期和舒张末期容积方面不太准确。