Assessment Of Left Ventircular Systolic And Diastolic Synchrony In Patients With Dilated Cardiomyopathy By Real-time Three-dimensional Echocardiography

Objective:To evaluate the left ventricular systolic and early diastolic synchrony and understand global left ventricular and segmental systolic, diastolic function in patients with dilated cardiomyopathy (DCM) by real time three-dimensional echocardi-ography.Methods:27healthy subjects(control group) and37patients with DCM (DCM group)were examined by RT-3DE, the left ventricular end diastolic volume (EDV)> left ventricular end systolic volume (ESV), left ventricular ejection fraction (LVEF)were obtained, the percentage of time of early diastolic/diastolic volume(EDV^/EDV) was calculated; myocardial motion amplitude and systolic synchronicity was analyzed by illustration of the bull eye(IBE). RT-3DE volume-time curves of two groups were analyzed by Q-lab software, standard deviation of time to minimal systolic volume(Tmsv-SD), and standard deviation of time to early diastolic volume (Tedv-SD) about16,12,6segments were obtained, and standardized using R-R interval as systolic dyssynchrony index (SDI)and early diastolic dyssynchrony index(DDI). Mean+3SD of the Tmsv16-SD%, Tedv16-SD%in control group were used as cut-off value to define Left ventricular(LV) systolic and early diastolic synchrony. The value exceed the cut-off was considered dyssynchrony.Results:①LVEF in DCM group was lower, EDV、ESV、(EDV(?)/EDV)%were higher.②The color was uniform、bright in the control group’s IBE, it showed a range of motion and good synchronization, The color was dark、disturbed in the DCM group’s IBE, it showed segmental motion was abnormal and had no distribution rule.③Compared with control group, SDI and DDI were higher in DCM group. all people existed systolic synchrony and most of people existed early diastolic synchrony in the control group.most of the patient existed more early diastolic dyssynchrony and less systolic dyssynchrony in the DCM group. LVEF<30%group existed more systolic and early diastolic dyssynchrony, compared with the LVEF>30%group, systolic dyssynchrony and early diastolic dyssynchrony didn’t exist in the DCM group together.④SDI and DDI had negative correlation with LVEF in DCM group.Conclusion:①RT-3DE’s IBE and VTC can be used to evaluate left ventricular wall motion, myocardial function and synchrony.②Myocardial systolic and diastolic function decreased obviously in the dilated cardiomyopathy.③There were the left ventricular systolic and early diastolic synchrony in patients with dilated cardiomyopathy, but they didn’t exist together.