| Echocardiography had been one of the important clinical evaluation ways of cardiac function in patients with DCM. The recently developed real-time3-dimensional echocardiography (RT-3DE) provides fast and non-invasive3Destimates with high image resolution that are more accurate and physiologic thanthose measured by conventional imaging techniques, for a more comprehensiveand detailed understanding left ventricular systolic function of patients with DCM,Real-time three-dimensional echocardiography provide some unique functionparameters in left ventricular systolic function. On account of the above facts, thecontents of this study were the following:1. Assessment the left ventricular systolic function of healthy volunteers andDCM patients80healthy volunteers were assigned to three groups by age, young age group(18-44years old), middle age group(45-59years old), older age group(≥60yearsold), simultaneously50DCM patients and50age and sex matched normalcontrols were enrolled into this study.The results show significant differences between normal controls and DCMpatients in unique function parameters of left ventricular systolic function,including ESSI(34.74±10.15)/(65.95±16.11)%,SDI(3.43±1.20)/(9.58±3.81)%,DISPES16(11.50±4.25)/(33.03±16.06)%,PostContr16(1.43±1.73)/(49.65±75.39)ml%, PreContr16(1.19±1.67)/(28.53±47.36)ml%,MES16(35.34±4.16)/(41.91±8.33)%, GLS(18.81±3.97)/(8.33±2.89)%,Twist (10.44±6.22)/(5.23±3.18)°and Torsion (1.27±0.82)/(0.57±0.34)°/cm (P﹤0.01). there was correlation between age andparameters such as ESSI,SDI,Twist and Torisonin in normal people,the value ofr was0.225,0.226,0.257,and0.290seperately(P﹤0.05)；there was correlationbetween EF and parameters such as SDI,GLS and Twist in DCM patients,thevalue of r was一0．697,0.756,0.300seperately(P﹤0.05).Seeing From the apex, counterclockwise for positive. The rotation direction ofLeft ventricule of DCM patients,the apex is positive in early systolic period, thenturn for negative rotation lately; Left ventricular baseline of starting performancenegative direction, then, with a positive direction; LV rotation performance earlyfor positive direction, late for negative direction. 2. Comparison of the assessment of left ventricular dyssynchrony by usingvector velocity imaging and Real-time3-dimensional echocardiographyIn40patients (mean age48±19years,60%men) intend to be treated with CRT,LV dyssynchrony was assessed using VVI and RT-3DE simultaneously, comparethe assessment results of the two methods. VVI and RT-3DE provide differentcharacterizations of left ventricular dyssynchrony, VVI assesses differences intime to peak systolic segmental myocardial tissue velocities(Ts-SD-12), whereasRT-3DE evaluates differences in time to minimum end-systolic regional volumes.Four patients (10%) were excluded from further analysis because of suboptimalimages, there was excellent agreement for the two methods and the kappa valuewas0.76(P＜0.01) and identifying patients with significant dyssynchrony wasobserved:61.1%for VVI versus66.7%for RT-3DE, and the average time ofanalysising each case was2.5±0.5hours for VVI versus15±5minutes forRT-3DE (P＜0.01).3. The application of Real-Time Three-Dimensional Echocardiography incardiac resynchronization therapy21DCM patients with heart failure who underwent cardiac resynchronizationtherapy were choosen,Real-Time Three-Dimensional Echocardiography is anovel quantitative technique that was applied to all patients before and post CRT.The results showed that: all patients had significantly left ventriculardyssynchrony, all patients successfully accepted CRT treatment, after an averageof six months of follow-up,16patients were responders and non-respondersefficiency is23%; cardiac function, clinical symptoms and left ventriculardyssynchrony significantly improved, the left ventricular dyssynchrony index ofreal-time three-dimensional echocardiography have good predictive value for CRT.the values of SDI was7.2%with91%sensitivity and86%specificity.Conclusions:1. With its unique left ventricular systolic function parameters, Real-timethree-dimensional echocardiography can give accurate, comprehensive anddetailed assessment of left ventricular systolic function.2. The left ventricular spherical index and left ventricular synchronicity of normal left ventricule are good, without delay or precontraction phenomenon.As the growth of the age, left ventricular systolic spherical index, and leftventricular dyssynchrony index have a trend of increase.3. The left ventricule of DCM patients turn into nearly spherical, left ventricularvolume increased, ejection fraction significantly reduced; there aresignificantly delay or precontraction phenomenon. Segmental contractiondispersion and left ventricular dyssynchrony index are increased.4. Seeing From the apex, counterclockwise for positive.The rotation direction ofthe apex is mainly positive; Left ventricular baseline performance negativedirection, LV rotation performance mainly for positive direction.5. With aging, LV rotation increased significantly in normal people.LV rotationparameters of DCM was significantly decreased, there was correlationbetween rotation parameters and EF in DCM patients..6. Real-Time Three-Dimensional Echocardiography can offer a more rapid andconvenient assessment of LV dyssynchrony and be more suitable for clinicalapplication in patient selection for CRT.7. DCM patients had significantly left ventricular dyssynchrony, CRT therapycan improve cardiac function, clinical symptoms and left ventriculardyssynchrony; SDI has good predictive value for CRT.
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