Assessment Of Ventricular Volume And Ejection Fraction In Congenital Heart Disease By Real-Time Three-Dimensional Echocardiography: A Exploration Study

Objective To evaluate the possibility and accuracy of real-time three-dimensional echocardiography(RT-3DE)in the quantitate assessment of the ventricular volume and ejection fraction in patients with congenital,heart disease,and to explore the superiority and the clinical value Of RT-3DE.Methds Sixty-four patients with congenital heart disease were studied by using RT-3DE.We quantitive assessed their left and right ventricular volume and ejection fraction,and compared them with thirty-four normal subjects; meanwhile,we compared the value measured by RT-3DE,two dimensional echocardiography(2DE)and M-mode echocardiography(M-ME),and through the result of comparing,evaluating the possibility and accuracy of measuring the ventricular volume and ejection fraction in patients with congenital heart disease by RT-3DE.Result(1)There was a good correlation between right ventricular volumes and SV obtained from 2DE and RT-3DE(r=0.903～0.970,P＜0.01);right ventricular volumes calculated from Simpson's rule in 2DE were significantly lower than those obtained from RT-3DE(P＜O.05),and right ventricular ejection fraction was no significant difference between them(P=0.300). (2)①There was a good correlation among left ventricular volumes obtained from M-E,RT-3DE and Simpson's rule(r=0.815～0.964,P＜0.01);②Left ventricular volumes calculated from RT-3DE were significantly less than those obtained from M-mode echocardiography(M-ME)but higher than from Simpson's rule(P＜0.05),and left ventricular function calculated from RT-3DE and Simpson's rule were significantly lower than that obtained from ME(P＜0.01),but no significant difference between themslves(P=1.000). (3)Left ventricular EDV,ESVand stroke volumne(SV),EF of patients with atrial septal defect(ASD)measured by RT-3DE were significantly lower than those obtained from normal subjects(P＜0.05);right ventricular volume and SV of patients with ASD were significantly higher than those obtained from normal subjects(P＜0.05),and right ventricular EF were significantly lower than those obtained from normal subjects(P＜0.05).(4)There were no significantly difference between left ventricular EF of patients With ventricular septal defect(VSD)and/or patent ductus arteriosus(PDA)and those obtained fromnormal subjects(P＞0.05),which were all measured by RT-3DE,and left ventricular EDV,ESVand SV of patients with VSD and/or PDA measured by RT-3DE were significantly higher than those obtained from normal subjects(P＜0.05);right ventricular EDV of patients with VSD and/or PDA were no significantly difference compared with those obtained from normal subjects(P＞0.05),but right ventricular ESV was significantly higher,and SV,EF lower than them,respectivly(P＜0.05).(5)There was no significantly difference between left ventricular SV and right ventricular SV(P=0.346＞0.05)which measured by RT-3DE in normal subjects,and in ASD patients,RV-SV was significantly more lager than LV-SV,and in VSD and/or PDA patients,they were opposite(P＜0.01).Conclusion Ventricular volumes and function in congenital heart disease (CHD)patients could be quantitive assessed by RT-3DE and Qtab analysis software,which had provided a new way to evaluate irregularity ventricular volumes and function,and would be had great value in clinical practice in the future.