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Oberjective To evaluate the left ventricular volume,systolic function and systolic synchronicity in heart failure of different step patients using real-time three dimensional echocardiography combine Tom Tec software 4D LV -Analysis system and primary manual tracking with semiautomated border detection. To discuss the feasibility and clinical value of real-time three-dimensional echocardiography evaluated of left ventricular function and contraction synchrony.Further explore the relationship between mechanical dyssynchrony and cardiac electrical activity .Methods forty patients with chronic heart failure caused by various reasons were referred as A group, forty patients with high risk factors of heart failure were referred as B group,and Thirty healthy volunteers were referred as C group.Full volume RT-3DE was performed by using GE ViVid 7.0.ultrsound imange device.Patients were left lateral position, the connection electrocardiogram.Routine two-dimensional echocardiography scanning, to obtain satisfactory apical four-chamber images, the subjects will urge end-expiratory breath-hold, Start "Full-volume" button, the ECG trigger for the "pyramid" full volume database.The 16-segmental time-volume curves were obtained by the off-line Tom Tec software 4D LV -Analysis system and primary manual tracking with semiautomated border detection.The time to minimal systolic volume(Tmsv) in each segment was taken to derive the following indexes of systolic asyn chrony:Tmsv16-SD,Tmsv16-Dif,Tmsv12-SD,Tmsv12-Dif,and the end-systolic volume (ESV),end-diastolic volume(EDV),left ventricular ejection fraction (LVEF) were derived. To make the data comparable,the above data by dividing the subjects of the cardiac cycle time (RR interval, in ms units) to standardized get Tmsvl6-SD%, Tmsvl2-SD%, Tmsvl6-Dif%, Tmsv12-Dif%.Conventional surface electrocardiogram for P-R interval and QRS duration.All parameters were dealed with statistics.Results①LVEDV、LVESV、LVEF and systolic asynchrony of A and B groups were significantly different,compared with C group (P<0.05).②There were significantly negative correlation between LVEF and the systolic synchrony parameters in A group,especially Tmsv16-SD% (r =—0.721,P<0.001), a weak relation was found between LVEF and QRS duration (r=0.314,P=0.049),and 27.5% of patients with QRS<120ms do exhibit of left ventricular dyssynchrony.③There were no significant relation between Tmsv16-SD% and LVEF,QRS duration in B group.Conclusions Real-time three-dimensional echocardiography as a fast, noninvasive, high- feasibility imaging methods which can quantify accurately the normal population, high-risk patients with heart failure, heart failure patients with left ventricular volume, function in the same cardiac cycle,and regardless of QRS inter-On whether to extend, can effective evaluate left ventricular systolic mechanical synchrony with chronic heart failure patients. Provide the convenient,effective,intuitive,reliable basis for the early intervention and treatment options of high risk heart failure and chronic heart failure patients.
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