Assessment Of Left Ventricular Motion Dyssychrony In Patients With Dilated Cardiomyopathy By Real-time Three-dimensional Echocardiography

Background The major clinical situation of dilated cardiomyopathy(DCM) is leftventricular or both ventricular dilatation, intractable heart failure. DCM may lead to ventricularwall motion to descend, accordingly to influence cardiac ejection. The study of cardiacresynchronization therapy (CRT) becomes a hot spot in heart diease therapy territory in patientswith heart failure, who do not respond to drug treatment very well and left ventriculardssynchrony. The admission rate and fatality of chronic cardiac failure patients were depressedobviously by CRT. It added the therapy of the final stage organic heart disease. However, studiesshow that symptoms of nearly 30 percent of patients did not improve obviously and even tointensify after CRT. The possible reason is that there is no better screening methods andparameters for patients with CRT. Real-time three-dimensional echocardiography as a newechocardiographic evaluation of left ventricular motion in dssynchrony has some advantages.RT-3DE geometry based on the actual measurement and calculation of ventricular volume andvarious parameters of cardiac function, and thus heart cavity deformation, wall motion is notsynchronized, such as pathological conditions is also available and accurate results.Objective To explore the clinical value of real-time three-dimensional echocardiography(RT-3DE) in assessment of the synchrony of left ventricle in patients with dilatedcardiomyopathy (DCM).Methods 30 patients with DCM and 20 healthy subjects were enrolled in this study. Thetime to the point with minimal systolic volume (Tmsv) in each segment were take to derive thefollowing indexes of systolic asynchrony : standard deviation (Tmsv16-SD, Tmsv12-SD,Tmsv6-SD), difference (Tmsv16-Dif, Tmsv12-Dif, Tmsv6-Dif)and each segments by R-Rinterval indexes: Tmsv16-SD%, Tmsv12-SD%, Tmsv6-SD%, Tmsv16-Dif%, Tmsv12-Dif%,Tmsv6-Dif% .Results Compared with healthy controls, Tmsv16-SD, Tmsv12-SD, Tmsv6-SD,Tmsv16-Dif, Tmsv12-Dif, Tmsv6-Dif, Tmsv16-SD%, Tmsv12-SD%, Tmsv6-SD%,Tmsv16-Dif%, Tmsv12-Dif%, Tmsv6-Dif% were increased in the DCM patients than those inthe healthy controls (P<0.05). Conclusion The left ventricular contractive dyssynchrony exists in patients with DCM,RT-3DE is a useful tool to assess left ventricular contractive synchrony in the patients withDCM．...