A Comparative Study Of The Left Ventricular Systolic Function In Patients With Coronary Artery Diseas By Real-time Three-dimensional Echocardiography And Two-dimensional Echocardiography

Objective : This study for comparing the differences between two-dimentional echocardiography (2DE) and real-time three– dimensional echocardiography(RT-3DE) in quantifying of left ventricular volumes and measuring the function of the patients with coronary artery disease,and then to assess the feasibility and accuracy of RT-3DE in quantifying the left ventricular volumes and ejection fraction(LVEF).Methods: 66 patients with coronary artery disease were divided into three groups according to echocardiography,that is group A:whose wall motion score index is 1;group B:whose wall motion score index is 2;and group C:whose wall motion score index is 3 or 4.Left ventricular end-diastolic volume (LVEDV), Left ventricular end-sistolic volume(LVESV)and left ventricular ejection fraction(LVEF) were measured by RT-3DE and 2DE on 66 patients with coronary heart disease, and then compared with single photo emission computer tomography(SPECT).One-factor ANOVA and tudent-newman Keuls was used for analysis of differences within variations.The linear correlation analysis was performed for RT-3DE relate to SPECT measurement and 2DE relate to SPECT measurement.Results:1. RT-3DE image with clear endocardium border was acquired in all but 1 patient.2. LVEDV, LVESV,and LVEF obtained by RT-3EDE were correlated highly with ECT.In group A,r=0.9923,0.9913,0.9858 respectively(P<0.0001);In group B, r = 0.9829, 0.9809,0.9339 respectively (P<0.0001);In group C,r =0.9524,0.9753,0.9374 respectively (P<0.0001).There were no significant difference for LVEDV,LVESV and LVEF between SPECT and RT-3DE(P>0.05).3. In group A,there was a good correlativity of LVEDV,LVESV and LVEF between 2DE and SPECT, r=0.9857,0.9861,0.9862 respectively.The LVEDV,LVESV and LVEF that were messured by two-dimensional echocardiography had no significant difference with that by ECT;In group B, there was a moderate correlativity of LVEDV,LVESV and LVEF between 2DE and SPECT, r=0.8454,0.7380,0.6747 respectively. The LVEDV , LVESV and LVEF that were messured by two-dimensional echocardiography had significant difference with that by SPECT(P<0.05); In group C,The LVEDV, LVESV,and LVEF were obtained by 2DE and ECT, there was a poor correlativity each other(r=0.0742,0.2116,0.3974 respectively). The LVEDV ,LVESV and LVEF that were messured by two-dimensional echocardiography had significant difference with that by SPECT(P<0.05). Comparing with SPECT, left ventricular end-diastolic and left ventricular end-systolic volume were underestimated by 2DE,while left ventricular ejection fraction was overestimated by 2DE.Conclusion:1. RT-3DE is a feasible and reliable method in quantifying left ventricular volumes and function.2. The value in measuring left ventricular function is deviated by using two-dimensional echocardiography,especially in patients with coronary heart disease.