摘要
前言
随着人民生活水平的提高和人口老龄化，冠心病(coronary artery disease，CAD)的发病率与死亡率呈迅速上升趋势。据调查，目前我国冠心病患者达6千万，每年死于各种冠心病的人数超过100万，而且发病率呈难以控制的上升趋势，近10年来，男性冠心病发病率较以往同期增加26．1％，女性增加19．0％；并有日趋年轻化的趋势，40岁以下青年冠心病患者现在已经占总发病人数的4．3％，35岁以下的青年人群患冠心病的比例也在不断上升。冠心病目前已成为对我国人民群众健康的最大威胁之一。
在冠心病病变的进程中，随着冠状动脉病变程度的加重和累及冠脉支数的增多，心肌受损，左室必将发生形态、大小和功能的改变，即左室重构。冠心病治疗方法多种多样，其中冠状动脉旁路移植术(coronary artery bypass grafting，CABG)已成为部分冠心病患者的有效治疗方法之一，它通过重建冠脉血液循环，为缺血的心肌恢复血供氧供，恢复因缺血而受损的心肌功能，同时恢复血流的冠状动脉又可为多支血管病变者提供侧支供血来源，因此能减少心肌坏死、限制梗死范围及透壁程度，从而改善或恢复存活心肌(包括冬眠心肌、顿抑心肌和伤残心肌)的功能，有效地抑制左室重构，改善左室功能。
传统二维超声心动图(two-dimensional echocardiography，2DE)以其简单方便、可重复测量等优点成为目前临床上评价左室形状、大小和功能的首选方法，对于正常形状的左室结构和功能的测量有很高的准确性，其基本原理是将左室假设为一近似真实心腔形态的几何模型，然后在统一的标准切面上进行测量，并通过特定公式计算左室形状、容积、质量、心功能等。但在病变情况下，如果心室腔形状偏离了假设模型，或在检查过程中需要的切面未能获得，则测量值与实际值之间会存在较大的误差。而且，在临床实践中，重构的左室腔不仅增大、变形，甚至局部室壁运动异常，或在一个心动周期可能有多种异常改变，此时所取的切面未必是标准切面，若用固定公式来计算变形的左室，得出的有关左室结构和心功能参数的测量值肯定会偏离实际值。静态与动态三维超声心动图(static three-dimensional echocardiography，dynamic three-dimensional echocardiography)需要心电呼吸门控、获取三维数据时间长、过程复杂、后处理慢等缺点而限制了其临床应用。实时三维超声心动图(real-time three-dimensional echocardiography，RT-3DE)是2000～2002年由Philips公司推出的一项新技术，经过数年的发展已经趋向于成熟，近年来的动物实验和临床研究均已证明，RT-3DE能实时、方便、准确地获取感兴趣区的立体数据库，并能直观地显示重构左室腔的立体结构及其在心动周期中的变化，以及对心肌梗死形成的室壁瘤均能真实显示。因此在心腔形状、容积、心功能、心肌的收缩和灌注异常等方面，特别是重构的左室结构和心功能的定量研究占有优势，显著高于M型和二维超声心动图。
本文旨在充分发挥RT-3DE的优势，探讨RT-3D测量的左室重构指数(leftventricular remodeling index，LVRI)、左室射血分数(left ventricular ejection fraction，LVEF)、左室局部峰值射血率(regional peak ejection ratio，rPER)，左室局部峰值充盈率(regional peak filling ratio，rPFR)、左室整体峰值射血率(global peak ejectionratio，gPER)、左室整体峰值充盈率(global peak filling ratio，gPFR)评价冠心病及CABG术效果的临床价值，以期为临床冠心病的诊治发挥更大的作用。本研究拟分为以下三部分：
第一部分实时三维超声心动图评价冠心病患者左室重构指数的初步研究
根据冠状动脉造影结果和临床资料将研究对象分为左旋支或／和右冠支病变组(LCX／RCA组)24例、单纯左前降支病变组(LAD组)21例、包含LAD病变的双支或多支病变组(多支组)27例，以及正常对照组22例，应用RT-3DE采集上述研究对象的左室全容积三维图像，在TomTec公司的4D LV analysis CAP 2．5分析软件上分别于左室收缩末期、舒张末期在心尖四腔心、三腔心、两腔心切面勾画左室心内膜及心外膜，软件自动测量出左室舒张末期容积(LVEDV)、左室舒张末期心外膜容积(LVEDVepi)，左室收缩末期容积(LVESV)，左室射血分数(LVEF)；再计算左室质量[LVM=1．05×(LVEDVepi-LVEDV)]、以及LVRI=LVM／LVEDV；并采用2DE双平面Simpson测量并计算上述各值。比较RT-3DE和2DE Simpson测量的LVEDV、LVRI、LVEF在各组间的差异，各组内的差异和相关性，以及RT-3DE和2DE Simpson测量的LVRI与LVEF、LVRI与LVEDV的相关性。以及观察者之间及观察者内RT-3DE和2DE测量LVRI的一致性和重复性。结果显示RT-3DE和2DE测量的LVRI、LVEF在正常对照组、LCX／RCA组、LAD组、多支组呈显著性递减，LVEDV呈显著性递增。RT-3DELVEDV：(74．82±10．43)ml vs(89．72±11．17)ml vs(101．27±19．58)ml vs(116．9±18．13) ml，RT-3DE LVRI：1．85±0．06 vs 1．75±0．11 vs 1．64±0．15 vs1．50±0．22及RT-3DE LVEF：(63．26±4．93)％vs (55．34±7．24)％vs(49．30±9．74)％vs (42．17±11．55)％(P＜0．05或P＜0．01)；2DE LVEDV：(74．58±9．95)ml vs(87．76±8．99)ml vs(95．86±17．60)ml vs(110．30±17．68)ml，2DE LVRI：1．86±0．05 vs 1．78±0．12 vs 1．70±0．09 vs 1．59±0．17及2DELVEF：(64．31±4．43)％vs(56．43±5．97)％vs(50．70±9．26)％vs(45．78±9．99)％(P＜0．05或P＜0．01)。RT-3DE和2DE两种方法测量的LVEDV、LVRI、LVEF在正常组及LCX／RCA组差异无统计学意义(P＞0．05)，在LAD组及多支组差异均有统计学意义(P＜0．05或P＜0．01)。相关性分析表明：1．除多支组内RT-3DE和2DE测量的LVRI无显著相关性(r=0．36，P＞0．05)外，RT-3DE和2DE测量的LVEDV、LVRI、LVEF在正常对照组、LCX／RCA组、LAD组、多支组均呈显著相关性(r=059～0．99，均P＜0．01)。2．RT-3DE和2DE测量的LVRI与LVEF在LCX／RCA组、LAD组、多支组均呈显著相关性(RT-3DE r=0．86、0．82、0．74，2DE r=0．78、0．86、0．59，均P＜0．01)，但正常组内无显著相关性(RT-3DE r=0．10，2DE r=0．28，均P＞0．05)。3．RT-3DE和2DE测量的LVRI与LVEDV在LCX／RCA组、LAD组、多支组均呈显著负相关性(RT-3DE r=-0．49、-0．77、-0．91，2DE r=-0．62、-0．83、-0．91，P＜0．05或P＜0．01)，但正常组内无显著相关性(RT-3DE r=0．12，2DE r=0．09，均P＞0．05)。RT-3DE测量的LVRI值观察者间及观察者内一致性和重复性较2DE好。
第二部分实时三维超声心动图容积-时间曲线评价冠心病患者左室局部与整体心功能的研究
本部分以冠状动脉造影示冠状动脉主要分支直径狭窄≥50％为阳性标准，将研究对象分为左旋支或／和右冠支病变组(LCX／RCA组)24例、单纯左前降支病变组(LAD组)21例、包含LAD病变的双支或多支病变组(多支组)27例及正常对照组22例，应用RT-3DE采集各研究对象的左室全容积三维图像，在TomTec公司的4D LV analysisCAP 2．5分析软件上分别于左室收缩末期、舒张末期在心尖四腔心、三腔心、两腔心切面勾画左室心内膜，获得左室整体与17节段容积时间曲线(volume-timecurve，VTC)，从VTC的数据库Excel表中得到gPFR、rPFR及LVEF。结果显示所有研究对象均获得满意的RT-3DE图像。1．正常对照组、LCX／RCA组、LAD组、多支组间gPER：(296．60±118．69)ml／s vs(225．49±89．52)ml／s vs(162．09±46．58)ml／svs(95．80±47．46)ml／s、gPFR：(209．69±101．65)ml／s vs(152．75±69．66)ml／s vs(106．77±34．54) ml／s vs(58．88±30．60)ml／s、LVEF：(63．27±4．92)％vs(55．33±7．18)％vs(49．48±9．38)％vs(42．11±11．49)％依次显著递减(P＜0．05或P＜0．01)；2．除LAD组、多支组下壁中间段的rPFR值，以及LCX／RCA组、LAD组、多支组部分心尖帽、下壁心尖段、侧壁心尖段的rPFR／rPER值，其余不同部位狭窄的冠状动脉所供血节段的rPER、rPFR较之相应正常冠状动脉所供血节段的rPER、rPFR显著减低(P＜0．05或P＜0．01)。相关性分析表明各组内gPER与gPFR(r=0．977～0．985，均P＜0．01)、以及gPER及LVEF值间(r=0．878～0．980，均P＜0．01)呈良好的相关性，各组各节段内rPER与rPFR亦呈良好的相关性(r=0．891～0．99，均P＜0．01)。
第三部分实时三维超声心动图左室重构指数与心功能测量评价冠脉搭桥术效果的研究
52例研究对象分成正常对照组与CABG组。使用Philip iE33 RT-3DE全容积探头采集正常对照组和CABG术前三天内、CABG术后一周、CABG术后一月三个时间点的各研究对象的左室Full Volume三维图像；于TomTec 4D LV analysis CAP 2．5分析软件的三维工作站上，测量LVEDV、LVESV、LVEDVepi，分析软件自动获得LVEF，再从获得的VTC的数据库Excel表中得到gPER和gPFR。并计算左室质量、LVRI。比较各组各时间点内LVRI、LVEF、gPER、gPFR之间的关系，以及LVRI、LVEF、gPER、gPFR在正常对照组与CABG组的差异及在CABG手术前后的变化情况。结果显示CABG术前及术后一周、一月的LVRI、LVEF、gPER、gPFR均较正常对照组显著减低。CABG术前vs CABG术后一周vs CABG术后一月vs正常对照组的比较显示，LVRI：1．59±0．16 vs 1．62±0．17 vs 1．71±0．15 vs 1．85±0．06，LVEF：(43．46±11．88)％vs(44．18±10．47)％vs ( 51．55±9．36)％vs(63．26±4．93)％，gPER：(102．33±48．50)ml／s vs (105．16±49．51)ml／s vs(197．22±73．81)ml／s vs(296．60±118．69)ml／s，gPFR：(63．02±32．91)ml／s vs(66．59±34．78)ml／s vs(139．81±54．65)ml／s vs ( 209．69±63．02)ml／s；均P＜0．01)。CABG组中LVRI、LVEF、gPER、gPFR手术前后的比较显示，CABG术后一周较CABG术前无显著改变(LVRI：1．62±0．17 vs 1．59±0．16，LVEF：(44．18±10．47)％vs (43．46±11．88)％，gPER：(105．16±49．51)ml／s vs(102．33±48．50)ml／s，gPFR：(66．59±34．78)ml／s vs(63．02±32．91)ml／s；均P＞0．05)、CABG术后一月较CABG术前显著增高(LVRI：1．71±0．15 vs 1．59±0．16，LVEF：(51．55±9．36)％vs (43．46±11．88)％，gPER：(197．22±73．81)ml／s vs(102．33±48．50)ml／s，gPFR：(139．81±54．65)ml／s vs(63．02±32．91)ml／s，均P＜0．01)。相关性分析表明：LVEF与gPER、gPER与gPFR在正常对照组、CABG术前、CABG术后一周、CABG术后一月均有显著相关性(LVEF与gPER：r=0．977，0．898，0．957，0．855；gPER与gPFR：r=0．975，0．983，0．982，0．974；均P＜0．01)；CABG术前、CABG术后一周及术后一月的LVRI与LVEF，LVRI与gPER及LVRI与gPFR均有显著相关性(LVRI与LVEF：r=0．803，0．890，0．738；LVRI与gPER：r=0．805，0．928，0．762；LVRI与gPFR：r=0．764，0．919，0．705；均P＜0．01)，但正常组内均无显著相关性(r=0．096，0．134，0．117；均P＞0．05)。
结论
1．RT-3DE与2DE测量的LVRI均能评价冠心病的左室重构，反映左室收缩功能；RT-3DE测量的LVRI能更准确评价左室重构，有望为临床评价左室重构提供一种新的方法。
2．RT-3DE容积-时间曲线测量指标rPER、rPFR、gPER、gPFR、LVEF能准确评价冠心病患者左室局部与整体心功能。
3．RT-3DE测量的LVRI与gPER、gPFR、LVEF联合应用，可更好地评价冠心病患者的左室重构与心功能变化。
4．RT-3DE测量指标LVRI、gPER、gPFR、LVEF可综合评价CABG术效果。
Preface
The morbidity and mortality of coronary artery disease(CAD)has rapidly increasedwith the improvement of the standard of living and the development of the aging.According to investigations of population,there are 60,000,000 cases of CAD in China,andthe cases dead of CAD were more than 1,000,000 every year.In recent decade,Themorbidity rate of man and women increased 26.1% and 19.0%,respectively,comparedwith the same period of last decade.Moreover,the patients with CAD become more young.The morbidity ratio among the youngs who were less than 40 years was 4.3% .Themorbidity ratio of young with CAD who are less than 35 years is continously increasing.CAD has been becoming one of diseases that seriously threaten the healthy of people.
With progression of CAD and the increasing numbers of the involved coronaryarteries,left ventricle(LV) will develope modification in shape,size,and function whichare defined as left ventricular remodeling .These changes will play great role in diagnosing,making decisions and evaluating prognosis.Coronary artery bypass grafting(CABG) thatcan provide blood supply for the ischemic myocardium has become one of effectiveapproaches to treat CAD resulted by the entire closure or serious stenosis of coronaryartery.The bridge grafting artery can reopen the collateral circulation for ischemicmyocardium,which effectively results in restraining LV remodeling and improving LVfunction as well as reducing myocardial necrosis,restraining infarction areas and penetrate degree which improves or restores surviving myocardial (hibernation myocardium,stunnemyocardium and injured myocardium) function.
Conventional 2DE has become first choice in asseement of LV remodeling and heartfunction because of its simpleness,convenience and reproducibility.The results measuredby 2DE is thought to be accurate in patients with normal LV shape which is assumpted as aregular geometric model.Then ,the regular geometric model volume of LV are measured atthe 2DE standard planes and calculated by a specific formula .However,the results isinaccurate under the condition of the changed shape of LV measured by 2DE as the actualshape of LV is totally different with the geometric model assumption.Previous clinicpractices had showed that conventional transthoracic 2DE were not ideal tool for accuratequantification of left ventricular volume as this method is subjected to two dimensionalplanes.
RT-3DE can conveniently acquire the whole dataset of the stereo structures in theinteresting region and directly display the shape of the remodeled LV such as aneurysm.Recently,animal researches and clinic studies showed that RT-3DE had resolved majorlimitations of 2DE and could significantly improve the accuracy of these measurements ofLV volume,mass ,function and wall motion by a fast way.The results obtained byRT-3DE have good agreement with those obtained by Cardiac Magnetic Resonance(MRI).
The aim of this study is to assess CAD's LV remodeling and its function before andafter CABG using parameters such as left ventricular remodeling index (LVRI),leftventricular ejection fraction(LVEF),regional peak ejection ratio(rPER),regional peakfilling ratio (rPFR),global peak ejection ratio (gPER),global peak filling ratio (gPFR)measured by RT-3DE.The dissertation includes three parts as following:
Part 1 Real-time Three-dimensional Echocardiographic Assessment of LeftVentricular Remodeling Index in Patients with Coronary Artery Disease
In the part,according to the results of coronary artery angiography,single main vessel stenosis which was eqeal to or larger than 50% was defined as recruited standard ,RT-3DE was carried out in 24 patients with left circumflex coronary artery or/and rightcornary artery stenosis (LCX/RCA group),21 patients with left anterior descendingcoronary artery stenosis (LAD group),27 patients with double or triplex coronary arteriesstenosis which must include LAD(Vessels group)and 22 subjets (normal controls group).The rate of cases with angina,acute myocardial infarction,and old myocardial infarctionwas 1/3 in every CAD group ;and the rate of cases with mild,moderate,severe coronaryartery stenosis was 1/3 in every CAD group.Left ventricular end-diastolic volume(LVEDV),left ventricular end-diastolic epicardial volume (LVEDVepi),left ventricularejection fraction (LVEF) were automatically measured by 4D LV analysis CAP 2.5software of TomTec company;left ventricular mass [ LVM=1.05×(LVEDVepi-LVEDV)],LVRI (LVM/LVEDV)were calculated.All above parameters were measured andcalculated in the same manner by 2DE Simpson biplane method.The inter-group differencesof LVEDV,LVRI,LVEF measured by RT-3DE and 2DE;and the intra-group differencesand correlations of LVEDV,LVRI,LVEF between RT-3DE and 2DE;and the correlationsbetween RT-3DE LVRI and LVEF,LVRI and LVEDV;correlations between 2DE LVRI andLVEF LVRI and LVEDV in normal controls group,LCX/RCA group,LAD group ,andVessels group were analyzed.RESULTS RT-3DE and 2DE LVRI and LVEF significantlydecreased in order,LVEDV significantly increased in order in normal controls group,LCX/RCA group,LAD group and Vessels group,respectively.RT-3DE LVEDV:(74.82±10.43)ml vs (89.72±11.17) ml vs (101.27±19.58) ml vs (116.79±18.13) ml,RT-3DE LVRI:1.85±0.06 vs 1.75±0.11 Vs 1.64±0.15 vs 1.50±0.22 ,and RT-3DE LVEF:(63.26±4.93)%vs (55.34±7.24) % vs (49.30±9.74) % vs (42.17±11.55)%,( all P＜0.05 or P＜0.01);2DE LVEDV:(74.58±9.95)ml vs (87.76±8.99)ml vs (95.86±17.60)ml vs (110.30±17.68)ml,2DE LVRI:1.86±0.05 vs 1.78±0.12 vs 1.70±0.09 vs 1.59±0.17,and 2DE LVEF:(64.31±4.43) % vs (56.43±5.97) % vs (50.70±9.26) % vs (45.78±9.99) %;(all P＜0.05or P＜0.01).LVEDV.LVRI,LVEF measured by RT-3DE and 2DE were significant difference in LAD group and Vessels group ( P＜0.05 or P＜0.01);but no significantdifference in normal controls group and LCX/RCA group ( P＞0.05) .The correlationanalysis indicated that:1.There were significant correlations of LVEDV、LVRI、LVEFbetween RT-3DE and 2DE in normal controls group ,LCX/RCA group,LAD group andVessels group(r=059～0.99,all P＜0.01 ),except for LVRI measured by RT-3DE and 2DEin Vessels group(r=0.36,P＞0.05).2.There were significant correlations betweenRT-3DE LVRI and LVEF (r=0.86,0.82,0.74,all P＜0.01) ;between 2DE LVRI andLVEF(r=0.78,0.86,0.59,all P＜0.01) in LCX/RCA group,LAD group and Vessels group,respectively;but no significant correlation ( RT-3DE r=0.10,2DE r=0.28,all P＞0.05) innormal controls group.2.There were significant negative correlations between RT-3DELVRI and LVEDV (r=-0.49,-0.77,-0.91,all P＜0.05 or P＜0.01) ;between 2DE LVRIand LVEDV(r=-0.62,-0.83,-0.91,all P＜0.01) in LCX/RCA group ,LAD group andVessels group,respectively;but no significant conrelations ( RT-3DE r=0.12,2DE r=0.09,all P＞0.05)in normal controls group.The good agreement and reproducibility ofLVRI measured by RT-3DE were found superior to 2DE.Part 2 Clinical Study of Left Ventricular Regional and Global Function byReal-time Three-dimensional Echocardiographic Volume-time Curve in Patients withCoronary Artery Disease
To assess the feasibility and accuracy of RT-3DE VTC in quantifying regional andglobal left ventricular systolic and diastolic function in patients with CAD.According tocoronary artery angiography ,single main vessel stenosis eqeal to or larger than 50% wasdefined as positive standard .Full volumetric RT-3DE data of 24 patients with leftcircumflex coronary artery or/and right coronary artery stenosis (LCX/RCA group ) ,21patients with single left anterior descending coronary artery stenosis ( LAD group) ,27patients with double or triplex coronary arteries stenosis,which must include LAD(Vesselsgroup)and 22 subjects (normal controls group) were acquired.The rate of cases with angina, acute myocardial infarction,and old myocardial infarction was 1/3 in every CAD group ;and the rate of cases with mild,moderate,severe coronary artery stenosis was 1/3 in everyCAD group.The gPER,rPER,gPFR,rPFR and LVEF were obtained by 4D LV analysisCAP 2.5 software of TomTec company.RESULTS The gPER:(296.60±118.69) ml/s vs(225.49±89.52) ml/s vs (162.09±46.58) ml/s vs (95.80±47.46) ml/s,gPFR:(209.69±101.65) ml/s vs (152.75±69.66) ml/s vs (106.77±34.54) ml/s vs (58.88±30.60)ml/s,LVEF:(63.27±4.92)% vs (55.33±7.18)% vs (49.48±9.38)% vs (42.11±11.49)%significantly decreased in order ( all P＜0.05 or P＜0.01 ) in normal controls group,LCX /RCA group,LAD group,Vessels group,respectively.The other rPER,rPFR ofcorresponding sections where coronary artery had positive stenosis were significantlylower than those of corresponding sections where coronary artery had no positive stenosisinter-group ( P＜0.05 or P＜0.01 ),respectively,except rPFR of mid inferiorin in LAD groupand Vessels group,rPFR and or rPER of partial apical inferior,apical lateral and apex inLCX / RCA group,LAD group,and Vessels group.Correlation analysis indicated that goodpositive correlations between gPER and gPFR ( r =0.975,0.985,0.977,0.983,all P＜0.01),between gPER and LVEF ( r =0.980,0.878,0.951,0.972,all P＜0.01) in normal controlsgroup ,LCX/ RCA group,LAD group,Vessels group,respectively;The good positivecorrelations between rPER and rPFR of each section ( r=0.891～0.990,all P＜0.01)were found.
Part 3 Real-time Three-dimensional Echocardiographic Analysis of LeftVentricular Remodeling Index and Heart Function in Evaluating the Effect ofCoronary Artery Bypass Grafting
To evaluate the effect of CABG with left LVRI and heart function using RT-3DE.22 normal control subjects (normal control group) and 30 patients with CABG group( including pre-CABG ,one week after CABG ,one month after CABG subgroups) ofRT-3DE full volumetric dataset were acquired.LVEDV,LVESV,LVEDVepi,The gPER, gPFR,and LVEF in all cases were offline obtained by 4D LV analysis CAP 2.5 software ofTomTec company;LVM,LVRI were calculated.Then,the differences of LVRILVEF ,gPER,gPFR between normal controls group and CABG subgroup,betweenpre-CABG subgroup and one week after CABG subgroup/ one month after CABGsubgroup;the correlations between LVRI and gPER,LVRI and LVEF,gPER and gPFR innormal controls group ,CABG group were compared with.RESULTS LVRI ,LVEF ,gPER,gPFR of pre-CABG ,one week after CABG ,one month after CABG subgroupswere significant lower than those of normal controls group ( P＜0.05 );LVRI ,LVEF ,gPER,gPFR of one month after CABG subgroup were significant greater thanthose of pre-CABG subgroup,one week after CABG subgroup( P＜0.05 );but LVRI ,LVEF,gPER,gPFR of one week after CABG subgroup weren't significant dittiences fromthose ofpre-CABG subgroup ( P＞0.05 ).Correlation analysis indicated that good positivecorrelations between LVEF and gPER,between gPER and gPFR in normal control groupand CABG group;good positive correlations between LVRI and LVEF,LVRI and gPER inpre-CABG subgroup ,one week after CABG subgroup and one month after CABGsubgroup,but no good positive correlations between LVRI and LVEF,between LVRI andgPER in normal controls group were found.
CONCLUSIONS:
1.LVRI measured by RT-3 DE and 2DE can assess CAD' s left ventricular remodeling,and reflect its left ventricular systolic function;RT-3DE LVRI can take as a newapproach for evaluating left ventricular remodeling in clinic superior to 2DE.
2.RT-3DE VTC can provide a new noninvasive and accurate tool for assement of LVregional and global diastolic and systolic function in CAD with gPER,gPFR,rPER,rPFR,LVEF parameters.
3.RT-3DE can combinely assess left ventricular remodeling and heart function changesin patients with CAD by measuring LVRI,gPER,gPFR,LVEF.
4.RT-3DE is a new tool for clinical evaluation of CABG effects by combinely measuringLVRI,gPER,gPFR,LVEF before and after CABG.
引文
1.Opie LH,Commerford PJ,Gersh BJ,et al.Controversies in ventricular remodeling.Lancet,2006,367(9507):356-367.
2.Whalley GA,Doughty RN,Gamble GD,et al.A ssociation of fat free mass and training status with left ventricular size and mass in endurance trained athletes.J Am Coll Cardio 1,2004,18,44(4):892-896.
3.Arai K,Hozumi T,Matsumura Y,et al.Accuracy of measurement of left ventricular volume and ejection fraction by new real-time three-dimensional echocardiography in patients with wall motion abnormalities secondary to myocardial infarction.Am J Cardiol,2004,94(5):552-558.
4．郭盛兰，潘永寿，潘迪光，等．超声心动图检测高血压患者左室质量指数研究．中国超 声医学杂志，2006,22(2)：108-110．
5．胡少东，向华，马宁，等．早期再灌注对急性心肌梗死伴室壁瘤形成的阻抑效应和心功 能改善作用的超声心动图观察．中华超声影像学杂志，2005，14(3)：180-182．
6.De Castro S,Caselli S,Maron M,et al.Left ventricular remodelling index(LVRI)in various pathophysiological conditions:a real-time three-dimensional echocardiographic study.Heart,2007,93(2):205-209.
7.Caiani EG,Corsi C,Sugeng L,et al.Improved quantification of left ventricular mass based on endocardial and epicardial surface detection with real time three dimensional echocardiography.Heart,2006,92(2):213-219.
8．黄国倩，刘虹，舒先红，等．超声心动图评价粒细胞集落刺激因子动员自身骨髓干细胞 对心肌梗死后左心室重构及心功能的影响．中华超声影像学杂志，2004，13(11)： 848-852．
9．任文武．华琦，李康，等．冠状动脉病变与左室功能关系的临床观察．中国医学影像技 术，2001，17(6)：534-536．
10.Mannaerts HF,van der Heide JA,Kamp O,et al.Early identification of left ventricular remodeling after myocardial infarction,assessed by transthoracic 3D echocardiography. Eur Heart J,2004,25(8):680-687.
11.Vannan MA,Taylor DJ.Ventricular remodelling after myocardial infarction.Br Heart J,1992,68(3):257-259.
12．龚兰生，施仲伟，于金德．充血性心力衰竭．上海：上海科学技术出版社，2002．51-60．
13.Goldstein S,Ali AS,Sabbah H.Ventricular remodeling.Mechanisms and prevention.Cardiol Clin,1998,16(4):623-632.
14．中华医学会心血管病学分会．慢性收缩性心力衰竭治疗建议．中华心血管病杂志， 2002，30(1)：7-23．
15．刘望彭，王宏宇，李玉梅，等．超声心动图对急性心肌梗塞后左心室结构和功能的评 价．中华超声影像学杂志，1999，18(3)：145-147．
16.Pfeffer MA.Braunwald E.Ventricular remodeling after myocardial infarction:Experimental observations and clinical implications.Circulation,1990,81(4):1161-1172.
17．张鸿修，黄体钢．主编．实用冠心病学．第四版．天津：天津科技翻译出版公司．2005．1： 841．
18.Cohn JN.Structural basis for heart failure:ventricular remodeling and its pharmacological inhibition.Circulation,1995,91(10):2504-2507.
19．章朝霞，潘翠珍，舒先红，等．实时三维超声心动图定量评价左室容积及其收缩功能的 研究．中国超声医学杂志，2004，20(4)：265-268．
20.Silvermen NH,Ports TA,Snider AR,et al.Determination of left ventricular volume in children:echocardiographic and angiographic comparisons.Circulation,1980,62(3):548-557.
21.Hibberd MG,Chuang ML,Beaudin RA,et al.Accuracy of three-dimensional echocardiography with unrestricted selection of imaging planes for measurement of left ventri-cular volumes and ejection fraction.Am Heart J,2000,140(3):469-475.
22.Mannaerts HF,Van Der Heide JA,Kamp O,et al.Quantification of left ventricular volumes and ejection fraction using free hand transthoracic three-dimensional echocardiography:comparison with magnetic resonance imaging.J Am Soc Echocardiogr, 2003,16(2): 101-109.
23. Shiota T, McCarthy PM, White RD, et al. Initial clinical experience of real-time 3-dimensional echocardiography in patients with ischemic and idiopathic dilated cardio-myopathy. Am J Cardiol,1999,84(9): 1068-1073.
24. Qin JX, Jones M, Shiota T, et al. Validation of real-time three dimensional echocar-diography for quantifying left ventricular volumes in the presence of a left ventricular aneurysm: in vitro and in vivo studies. J Am Coll Cardiol,2000,36 (3):900-907.
25. Buck T, Hunold P, Wentz KU, et al. Tomographic three dimensional echocardiogra-phic determination of chamber size and systolic function in patients with left ventricular aneurysm: comparison to magnetic resonance imaging, cine ventriculography and two-dimensional echocardiography. Circulation, 1997,96 (12):4286-4297.
26. Monaghan MJ .Role of real time 3D echocardiography in evaluating the left ventricle.Heart,2006,92(1): 131-136.
27. Qi X, Cogar B, Hsiung MC, et al. Live/real time three-dimensional transthoracic echocardiographic assessment of left ventricular volumes,ejection fraction,and mass compared with magnetic resonance imaging. Echocardiography,2007,24(2): 166-173.
28. Lee D, Fuisz AR, Fan PH, et al . Real-time 3-dimensional echocardiography evaluat ion of left ven ricular v lume: correlation with magnet ic resonance imaging a validation study . J Am Soc Echocardiogr,2001,14 (10) : 1001-1009.
29. OtaT, Kisslo J ,Von Ramm OT, et al . Real-time volumetric echoardiography: usefulness of volumetric scanning for the assessment of cardiac volume and function . J Cardiol,2001,37 (Suppl1): 93-101.
30. Takuma S,OTA T,M uro T, et al . Assessment of left ventricular function by real-time 3-dimensional echocardiography compared with conventional noninvasive methods . J Am Soc Echocardiogr,2001,14 (4) : 275-284.
31. Wang XF, Deng YB, Nanda NC, et al . Live three-dimensional echocardiography:imaging principles and clinical application .Echocardiography,2003,20(7): 593-604.
32． 王新房．实时三维超声心动图-超声技术领域内的新突破．中华超声影像学杂 志，2003，12(2)：71-75．
33.Ota T,Kisslo J,von Ramm OT,et al.Real-time volumetric echoardiography:usefulness of volumetric scanning for the assessment of cardiac volume and function.J Cardiol,2001,37(Suppl 1):93-101.
34.Mor-Avi V,Sugeng L,Weinert L,et al.Fast measurement of left ventricular mass with real-time three-dimensional echocardiography comparison with magnetic resonance imaging.Circulation,2004,110(13):1814-1818.
35.Qi X,Cogar B,Hsiung MC,et al.Live/real-time three-dimensional transthoracic echocardiographic assessment of left ventricular volumes,ejection fraction,and mass compared with magnetic resonance imaging.Echocardiography,2007,24(2):166-173.
36.Guti(?)rrez-Chico JL,Zamorano JL,P(?)rez de Isla L,et al.Comparison of left ventricular volumes and ejection fractions measured by three-dimensional echocardiography versus by two-dimensional echocardiography and cardiac magnetic resonance in patients with various cardiomyopathies.Am J Cardiol,2005,95(6):809-813.
37.Jenkins C,Bricknell K,Hanekom L,et al.Reproducibility and accuracy of echocardiographic measurements of left ventricular parameters using real-time three-dimensional echocardiography.J Am Coll Cardiol,2004,44(4):878-886.
38.K(?)hl HP,Schreckenberg M,Rulands D,et al.High-resolution transthoracic real-time three-dimensional echocardiography:quantitation of cardiac volumes and function using semi-automatic border detection and comparison with cardiac magnetic resonance imaging.J Am Coll Cardiol,2004,43(11):2083-2090.
39.Jacobs LD,Salgo IS,Goonewardena S,et al.Rapid online quantification of left ventricular volume from real-time three-dimensional echocardiographic data.Eur Heart J,2006,27(4):460-468.
40.van den Bosch AE,Robbers-Visser D,Krenning B J,et al.Comparison of real time three-dimensional echocardiography to magnetic resonance imaging for assessment of left ventricular mass. Am J Cardiol.2006,97(1):113-117.
41. Oe H, Hozumi T, Arai K, et al. Comparison of accurate measurement of left ventricular mass in patients with hypertrophied hearts by real-time threedimensional echocardi-ography versus magnetic resonance imaging. Am J Cardiol,2005,95 (10): 1263-1267.
42. Corsi C, Lang RM , Veronesi F, et al.Volumetric quantification of global and regional left ventricular function from real-time three-dimensional echocardiographic images.Circulation,2005,112(8): 1161-1170.
43. Qin JX, Jones M, Shiota T, et al.Validation of real-time three-dimensional echocardi-ography for quantifying left ventricular volumes in the presence of a left ventriular aneurysm: in vitro and in vivo studies.J Am Coll Cardiol,2000,36 (3) : 900-907.
44. Schmidt MA, Freidlin RZ, Ohazama CJ, et al. Anatomic validation of a novel method for left ventricular volume and mass measurements with use of real-time 3-dmensional echocardiography. J am Soc Echocardiog,2001,14(1): 1-10.
45. Lee D, Fuisz AR, Fan PH,et al. Real-time 3-dimensional echocardiographic evaluation of left ventricular volume: correlation with magnetic resonance imaging--a validation study. J Am Soc Echocardiogr,2001,14(10):1001-1009.
46. Prakash K, Li X, Hejmadi A,et al. Determination of asymmetric cavity volumes using real-time three-dimensional echocardiography: an in vitro balloon model study.Echocardiography,2004,21(3):257-263.
47. Yao GH, Li F, Zhang C,et al. How many planes are required to get an accurate and timesaving measurement of left ventricular volume and function by real-time three-dimensional echocardiography in acute myocardial infarction?_Ultrasound Med Biol,2007,33(10):1572-1578.
48. Qin JX, Jones M, Travaglini A, et al. The accuracy of left ventricular mass determined by real-time three-dimensional echocardiography in chronic animal and clinical studies: a comparison with post mortem examination and magnetic resonance imaging.J Am Soc Echocardiogr,2005,18(10): 1037-1043.
49.Zhuang L,Xie MX,Wang WJ,et al.Quantitative assessment of myocardial perfusion defects with real-time three-dimensional myocardial contrast echocardiography.Chin Med Sci J,2006,21(3):135-139.
50.Sapin SM,Gopal AS,Clarke GB,et al.Three-dimensional echocardiography compared to two-dimensional echocardiography for measurement of left ventricular mass anatomic validation in an open chest canine model.Am J Hypertens,1996,9(5):467-474.
51.Camarano G,JonesM,Freidlin RZ,et al.Quantitative assessment of ventricular perfusion defects using real-time three-dimensionalmyocardial contrast echocardiography.J Am Soc Echocardiogr,2002,15(3):206-213.
52.Zeidan Z,Erbel R,Barkhausen J,et al.Analysis of global systolic and diastolic left ventricular performance using volume-time curves by real-time three-dimensional echocardiography.J Am Soc Echocardiogr,2003,16(1):29-37.
53.Zeidan Z,Buck T,Barkhausen J,et al.Real-time three-dimensional echocardiography for improved evaluation of diastolic function using volume-time curves.Herz,2002,27(3):237-245.
54．郭薇，陈斌，陈德伟．等．实时三维超声心动图左室容积-时间曲线定量分析缺血心肌 的临床意义．中国超声医学杂志，2006，22(4)：273-275．
55．谢明星，王新房，黄润青，等．实时三维超声心动图评价左室重构心功能的初步探讨． 中国医学影像技术，2003，19(5)：542-544．
1. Pomerantsev EV,Stertzer SH,Shaw RE.Quantitative left ventriculography:methods assessment of the regional contractility. J Invas Cardiol, 1995,7(1): 11-18.
2. Zeidan Z, Erbel R, Barkhausen J, et al . Analysis of global systolic and diastolic left ventricular performance using volume-time curves by real-time three-dimensional echocardiography. J Am Soc Echocardiogr,2003,16(1):29-37.
3. Nguyen LD, Leger C. Four dimensional reconstruction of the left ventricle using a fast rotating classical phased array scan head : preliminary results. J Am Soc Echocardiogr,2002,15(6): 593-600.
4. Zeidan Z , Buck T , Barkhausen J , et al . Real-time three-dimensional echocardiography for improved evaluation of diastolic function using volume-time curves . Herz,2002, 27(3):237-245.
5. von Bardeleben RS , K(?)hl HP , Mohr-Kahaly S , et al . Second generation real-time three-dimensional echocardiography. Finally on its way into clinical cardiology. Z Kardiol, 2004,93 (Suppl 4): ?56-64.
6. Cerqueria MD , Weissman NJ , Dilsizian V , et al . Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart. A statement for healthcare professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association. Circulation,2002,105(4) :539 -542.
7. Clements IP. Combined systolic and diastolic dysfunction in the presence of preserved left ventricular ejection fraction. European Journal of Heart Failure,2005,7(4): 490-497.
8. Higuchi T, Taki J, Nakajima K, et al. Left ventricular ejection and filling rate measurement based on the automatic edge detection method of ECG-gated blood pool single-photon emission tomography. Annals of Nuclear Medicine,2004,18(6): 507- 511.
9. Yamano T, Nakamura T, Sakamoto K, et al. Assessment of left ventricular diastolic function by gated single-photon emission tomography: comparison with Dopple echocardiography.Eur J Nucl Med Mol Imaging,2003,30(11):1532-1537.
10．费洪文，何亚乐，梁志敏，等．实时三维超声心动图容积-时间曲线评价左心室舒张功 能的初步研究．中华超声影像学杂志，2006，15(1)：9-12．
11．尤金布劳恩．心脏病学．第5版．北京：人民卫生出版社，2001．396-400．
12．沈文锦，徐成斌．现代心功能学．北京：人民卫生出版社，2002．102-114．
13.Stefanadis C,ManolisA,Dernellis J,et al.Acute effect of clonidine on left ventricular pressure-volume relation in hypertensive patients with diastolic heart dysfunction.J Hum Hypertens,2001,15(9):635-642.
14.Kudelka AM,Turner DA,Liebson PR,et al.Comparison of cine magnetic resonance imaging and Doppler echocardiography for evaluation of left ventricular diastolic function.Am J Cardiol,1997,80(3 ):384-386.
15.Vitarelli A,Luzzi MF,Penco M,et al.On-line quantitative assessment of left ventricular filling during dobutamine stress echocardiography:a useful addition to conventional wall motion scoring.Int J Cardiol,1997,59(1):57-69.
16.Wang XF,Deng YB,Nanda NC,et al.Live three-dimensional echocardiography:imaging principles and clinical application.Echocardiography,2003,20(7):593-604
17.Fei HW,Wang XF,Xie MX,et al.Validation of real-time three-dimensional echocardiography for quantifying left and right ventricular volumes:an experimental study.Chin Med J(Engl),2004,117(5):695-699.
18．王新房．实时三维超声心动图-超声技术领域内的新突破．中华超声影像学杂志， 2003，12(2)：71-75．
19．费洪文，王新房．实时三维超声心动图的应用概况．中华超声影像学杂志，2003，12(2)： 109-110．
20．费洪文，王新房，谢明星，等．实时三维超声心动图测量左心室容积的实验研究．中华 超声影像学杂志，2003，12(7)：426-429．
21.Collins M,Hsieh A,Ohazama CJ,et al.Assessment of regional wall motion abnormalities with real-time 3-dimensional echocardiography.J Am Soc Echocardiogr, 1999，12(1)：7-14．
22．陈娇，唐红，郭津含．实时三维超声心动图容量-时间曲线评价正常人左室局部舒张 功能的初步研究．中国医学影像技术，2005，21(7)：1030-1032．
23．郭薇，陈斌，陈德伟．等．实时三维超声心动图左室容积-时间曲线定量分析缺血心肌 的临床意义．中国超声医学杂志，2006，22(4)：273-275．
24．王雪，张梅，张运，等．实时三维超声对心肌梗死患者左心室局部心肌容量和收缩功 能的分析．中华超声影像学杂志，2006，15(5)：325-328．
25．张嬿，唐红，宋彬，等．实时三维超声心动图评价健康人左心室壁节段收缩功能的研 究．中华超声影像学杂志，2007，16(1)：5-8．
26.Banerjee AK,Madan Mohan SK,Ching GW,et al.Functional significance of coronary collateral vessels in patients previous“Q”wave infarction:relation to aneurysm,left ventricular end diastolic pressure and ejection farction.Int J Cardiol,1993,38(3):263-271.
27.Aronow WS,Epstein S,Koenigsberg M.Usefulness of echocardiographic left ventricular ejection fraction and silent myocardial ischemia in predicting new coronary events in elderly patients with coronay artery disease or systemic hypertension.Am J Cardiol,1990,65(11 ):811-822.
28.Grossman W.Diastolic dysfuncion and congestive heart failure.Circulation,1990,81:(2Suppl):Ⅲ1-7.
29.Nishimura RA,Abel MD,Hatle LK,et al.Assessment of diastolic function of the heart:background and current application of Doppler echocardiography.Part Ⅱ.Clinical studies.Mayo Clin Proc,1989,64(2):181-204.
30．周永昌，郭万学主编．超声医学．第5版．北京：科学技术文献出版社，2007．443-451．
31.Garcia-Fernandez MA,Azevedo J,Moreno M,et al.Regional left ventricular diastolic dysfunction evaluated by pulsed-tissue doppler echocardiography.Echocardiography,1999,16(5):491-500.
32．陈立军，李守平，李永青．心肌存活性对冠状动脉旁路移植术左心整体功能的影响． 中华超声影像学杂志，2000，9(3)：133-136．
33．任文武，华琦，李康，等．冠状动脉病变与左室功能关系的临床观察．中国医学影像技术，2001，17(6)：534-536．
34.Carabello BA,Nolan SP,McGuire LB.Assessment of preoperative left ventricular function in patients with mitral regurgitation:Value of the end-systolic wall stress-end-systolic volume ratio.Circulation,1981,64(6):1212-1217.
35.Poulsen SH,Jensen SE,Gzsche O,et al.of left ventricular diastolic function assessed by Doppler echocardiography in the early phase of a first acute myocardial infarction.Eur Heart J,1997,18(12):1882-1889.
36.Forster T,McGhie J,Rijsterborgh H,et al.Does the measurement of left ventricular isovolumic relaxation time allow early prediction of cardiac allograft rejection? Acta Cardiol,1992,47(5):459-471.
37．谢明星，王新房，黄润青，等．实时三维超声心动图评价左室重构心功能的初步探讨． 中国医学影像技术,2003，19(5)：542-544．
1．谭国娟，智光，徐勇．多普勒组织成像技术评估冠心病血运重建术整体心功能的临床 研究．中国超声医学杂志，2003，19(2)：139-144．
2．夏春霞，郭瑞强，周青，等．多普勒组织成像和应变率显像结合评价冠脉搭桥患者术 后左心功能的变化．中国医学影像技术，2005，21(12)：1899-1901．
3．田家玮，任敏．应变率成像对冠心病冠状动脉搭桥手术前后左心室局部收缩功能的 评价．中华超声影像学杂志，2006，15(6)：408-411．
4．任敏，田家玮．应变率成像对冠心病CABG手术前后左室局部舒张功能的评价．中国 超声医学杂志，2006，22(4)：270-272．
5.De Castro S,Caselli S,Maron M,et al.Left ventricular remodelling index(LVRI)in various pathophysiological conditions:a real-time three-dimensional echocardiogra-phic study.Heart,2007,93(2):205-209.
6.Ziad Z,Raimund E,Joerg B,et al.Analysis of global systolic and diastolic left ventricular performance using volume-time curves by real-time three-dimensional echocardiography.J Am Soc Echocardiogr,2003,16(1):29-37.
7.Zeidan Z,Buck T,Barkhausen J,et al.Real-time three-dimensional echocardiography for improved evaluation of diastolic function using volume-time curves.Herz,2002,27(3):237-245.
8.Caiani EG,Corsi C,Sugeng L,et al.Improved quantification of left ventricular mass based on endocardial and epicardial surface detection with real time three dimensional echocardiography.Heart,2006,92(2):213-219.
9．黄国倩，刘虹，舒先红，等．超声心动图评价粒细胞集落刺激因子动员自身骨髓干细胞 对心肌梗死后左心室重构及心功能的影响．中华超声影像学杂志，2004，13(11)： 848-852．
10.Wang XF,Deng YB,Nanda NC,et al.Live three-dimensional echocardiography:imaging principles and clinical application.Echocardiography,2003,20(7):593-604.
11.Fei HW,Wang XF,Xie MX,et al.Validation of real-time three-dimensional echocardiography for quantifying left and right ventricular volumes:an experimental study.Chin Med J(Engl),2004,117(5):695-699.
12．王新房．实时三维超声心动图-超声技术领域内的新突破．中华超声影像学杂志， 2003，12(2)：71-75．
13．费洪文，王新房．实时三维超声心动图的应用概况．中华超声影像学杂志，2003，12(2)： 109-111
14．费洪文，王新房，谢明星．实时三维超声心动图测量左心室容积的实验研究．中华超声影像学杂志，2003，12(7)：426-429．
15.Monaghan MJ.Role of real time 3D echocardiography in evaluating the left ventricle.Heart,2006,92(1):131-136.
16.Qi X,Cogar B,Hsiung MC,et al.Live/real-time three-dimensional transthoracic echocardiographic assessment of left ventricular volumes,ejection fraction,and mass compared with magnetic resonance imaging.Echocardiography,2007,24(2):166-173.
17.Corsi C,Lang RM,Veronesi F,et al.Volumetric quantification of global and regional left ventricular function from real-time three-dimensional echocardiographic images.Circulation,2005,112(8):1161-1170.
18.Krenning B J,Voormolen MM,Roelandt JR.Assessment of ventricular function by three-dimensional echocardiography.Cardiovasc Ultrasound,2003,1:12.
19.Collins M,Hsieh A,Ohazama CJ,et al.Assessment of regional wall motion abnormalities with real-time three-dimensional echocardiography.J Am Soc Echocardiogr,1999,12(1):7-14.
20.Nguyen LD,Leger C.Four dimensional reconstruction of the left ventricle using a fast rotating classical phased array scan head:preliminary results.J Am Soc Echocardiogr,2002,15(6):593-600.
21．陈娇，唐红，郭津含．实时三维超声心动图容量-时间曲线评价正常人左室局部舒张 功能的初步研究．中国医学影像技术，2005，21(7)：1030-1032．
22．郭薇，陈斌，陈德伟．等．实时三维超声心动图左室容积-时间曲线定量分析缺血心肌 的临床意义．中国超声医学杂志，2006，22(4)：273-275．
23．王雪，张梅，张运，等．实时三维超声对心肌梗死患者片心室局部心肌容量和收缩功 能的分析．中华超声影像学杂志，2006，15(5)：325-328．
24．张嬿，唐红，宋彬，等．实时三维超声心动图评价健康人左心室壁节段收缩功能的研 究．中华超声影像学杂志，2007，16(1)：5-8．
25.Opie LH,Commerford PJ,Gersh BJ,et al.Controversies in ventricular remodeling.Lancet,2006,367(9507):356-367.
26．龚兰生，施仲伟，于金德．充血性心力衰竭．上海：上海科学技术出版社，2002．51-60．
27.Goldstein S,Ali AS,Sabbah H,etal.Ventricular remodeling.Mechanisms and prevention.Cardiol Clin,1998,16(4):623-632.
28．中华医学会心血管病学分会．慢性收缩性心力衰竭治疗建议．中华心血管病杂志， 2002,30(1)：7-23．
29.Banerjee AK,Madan Mohan SK,Ching GW,et al.Functional significance of coronary collateral vessels in patients previous“Q”wave infarction:relation to aneurysm,left ventricular end diastolic pressure and ejection farction.Int J Cardiol,1993,38(3):263-271.
30.Aronow WS,Epstein S,Koenigsheng M.Usefulness of echocardiographic left ven-tricular ejection fraction and silent myocardial ischemia in predicting new coronary events in elderly patients with coronay artery disease or systemic hypertension.Am J Cardiol,1990,65(11):811-822.
31．任文武，华琦，李康，等．冠状动脉病变与左室功能关系的临床观察．中国医学影像技 术，2001，17(6)：534-536．
32.Preffer MA,Braunwald E.Ventricular remodeling after myocardial infarction.Experimental observations and clinical implications.Circulation,1990,81(4):1161-1172.
33．陈明，谢明星，王新房，等．实时三维超声心动图评价冠心病患者左心室重构指数与收 缩功能的研究．中华超声影像学杂志，2008，17(9)：737-740．
34.Cohn JN.Structural basis for heart failure.Ventricular remodeling and its pharmacological inhibition.Circulation,1995,91(10):2504-2507.
35.Dixon IM,Ju H,Jassal DS.Effect of ramipril and iosartan on collagen expression in right and left heart after myocardial infarction.Mol Cell Biochem.1996;165(1):31-45.
36.Sheiban I,Fragasso G,Lu C,et al.Influence of treatment delay on long left ventricular function in patients with acute myocardial infarction successfully treated with primary angioplasty.Am Heart J,2001,141(4):603-609.
37.Bax JJ,Van der Wall EE.Assessment of myocardial viability:guide to prognosis and clinical management.Eur Heart J,2000,21(12):961-963.
38．尤金布劳恩．心脏病学．第5版．北京：人民卫生出版社，2001．396-400．
39．沈文锦，徐成斌．现代心功能学．北京：人民卫生出版社，2002．102-114．
40．朱天刚，胡大一，陈方，等．冠脉内超声成像在冠状动脉内支架置入术中的应用．中华 超声影像学杂志，2000，9(7)：395-397．
41．江凤林，杨侃，梁中书．心肌梗死患者冠状动脉旁路移植术后左心室结构和功能变 化．中国心血管杂志，2005，10(6)：458-459．
42.Grossman W.Diastolic dysfuncion and congestive heart failure.Circulation,1990,81:(2Suppl):Ⅲ1-7.
43.Nishimura RA,Abel MD,Hatle LK,et al.Assessment of diastolic function of the heart:background and current application of Doppler echocardiography.Part Ⅱ.Clinical studies.Mayo Clin Proc,1989,64(2):181-204.
44．周永昌，郭万学主编．超声医学．第5版．北京：科学技术文献出版社，2007．445-451．
1.Dekker DL,Piziali RL,Dong E Jr.A system for ultrasonically imaging the human heart in three dimensions.Comput Biomed Res,1974,7(6):544-553.
2.Matsumoto M,Matsuo H,Kitabatake A,et al.Three-dimensional echocardiograms and two-dimensional echocardiographic images at desired planes by a computerized system.Ultrasound Med Biol,1977,3(2-3):163-178.
3.Matsumoto M,Inoue M,Tamura S,et al.Three-dimensional echocardiography for spatial visualization and volume calculation of cardiac structures.J Clin Ultrasound,1981,9(4):157-165.
4.Ghosh A,Nanda NC,Maurer G.Three-dimensional reconstruction of echocardiographic images using rotation method.Ultrasound Med Biol,1982,8(6):655-661.
5.Ralchlen JS,Trivedi SS,Herman GT,et al.Dynamic three-dimensional reconstruction of the left ventricle from two-dimensional echocardiograms.J Am Coll Cardiol,1986,8(2):364-370.
6．李英杰，于维汉，李天福，等．三维超声心动图．中国超声医学杂志，1987，15(4)： 62-64．
7.Pandian NG,Hsu TL,Schwartz SL,et al.Multiplane transesophageal echocardiography.Imaging planes,echocardiographic anatomy,and clinical experience with a prototype phased array OmniPlane probe.Echocardiography,1992,9(6):649-666.
8.yon Ramm OT,Smith SW.Real time volumetric ultrasound imaging system.J Digit Imaging,1990,3(4):261-266.
9.Sheikh KH,Smith SW,von Ramm OT,et al:Real-time,three-dimensional echocardiography:feasibility and initial use.Echocardiography,1991,8( 1):119-125.
10.Smith SW,Pavy HG,von Ramm OT.High-speed ultrasound volumetric imaging system.Part Ⅰ.transducer design and beam steering.IEEE Trans Ultrason Ferroeletr Frequency Control,1991,38(2):100-108.
11.Wang XF,Deng YB,Nanda NC,et al.Live three dimensional echocardiography: Imaging principles and clinical application.Echocardiography,2003,20(7):593-604.
12.Kisslo J,Firek B,Ota T,et al.Real-time volumetric echocardiography:the technology and the possibilities.Echocardiography,2000,17(8):773-779.
13.Lang R,Sugeng L.A fantastic journey:3D cardiac ultrasound goes live.Radiol Mange,2002,24(6):18-22.
14.Shung KK.The principle of multidimensional arrays.Eur J Echocardiogr,2002,3(2):149-153.
15．王新房．实时三维超声心动图—超声技术领域内的新突破．中华超声影像学杂志， 2003，12(2)：71-75．
16.Ota T,Kisslo J,von Ramm OT,et al:Real-time,volumetric echocardiography:usefulness of volumetric scanning for the assessment of cardiac volume and function.J Cardiol,2001,37(suppl 1):93-101.
17．王新房，李治安，谢明星，等．四维超声心动图的临床应用．中华心血管病杂志，1996， 24(1)：5-9．
18.Xie MX,Wang XF,cheng TO,et al.Real-time 3-dimensional echocardiography:a review of the development of the technology and its clinical application.Prog Cardiovasc Dis,2005,48(3):209-225.
19．李治安，马宁，杨娅，等．经食管实时三维超声心动图的临床应用．中华超声影像学杂 志，2007，16(11)：921-924．
20.M(?)ller S,Feuchtner G,Bonatti J,et al.Value of transesophageal 3D echocardiography as an adjunct to conventional 2 D imaging in preoperative evaluation of cardiac masses.Echocardiography,2008,25(6):624-631.
21．王新房．立体三维超声成像的原理和应用及其发展前景．中华超声影像学杂志， 2008，17(10)：915-917．
22.Teichholz LE,Kreulen T,Herman MV,et al.Problems in echocardiographic volume determinations:echocardiographic-angiographic correlations in the presence or absence of asynergy.Am J Cardiol,1976,37(1):7-11.
23.Wyatt HL,Meerbaum S,Heng MK,et al.Cross-sectional echocardiography.Ⅲ.Analysis of mathematic models for quantifying volume of symmetric and asymmetric left ventricles.Am Heart J,1980,100(6 Pt):821-828.
24.King DL,Gopal AS,King DL Jr,et al.Three-dimensional echocardiography:in-vitro validation for quantitative measurement of total and “infarct” surface area.J Am Soc Echocardiogr,1993,6( 1 ):69-76.
25.Handscumacher MD,Lethor JP,Siu SC,et al..A new integrated system for threedimensional echocardiographic reconstruction:development and validation for ventricular volume with application in human subjects.J Am Coll Cardiol,1993,21(3):743-753.
26.Gopal AS,Keller AM,Rigling R,et al.Left ventricular volume and endocardial surface area by three-dimensional echocardiography:comparison with twodimensional echocardiography and nuclear magnetic resonance imaging in normal subjects.J Am Coll Cardiol,1993,22(1):258-270.
27.Sapin PM,Schr(?)der KM,Gopal AS,et al.Comparison of two and three-dimensional echocardiography with cineventriculography for measurement of left ventricular volume in patients.J Am Coll Cardiol,1994,24(4):1054-1063.
28.Gopal AS,Shen Z,Sapin PM,et al.Assessment of cardiac function by threedimensional echocardiography compared with conventional noninvasive methods.Circulation,1995,92(4):842-853.
29.Jiang L,Vaquez de Prada JA,Handschumacher MD,et al.Quantitative threedimensional reconstruction ofaneurysmal left ventricles.In vitro and in vivo validation.Circulation,1995,91( 1 ):222-230.
30．谢明星，王新房，黄润青，等．实时三维超声心动图评价左室重构心功能的初步探讨． 中国医学影像技术，2003，79(5)：542-544．
31.Caiani EG,Corsi C,Zamorano J,et al.Improved semiautomated quantification of left ventricular volumes and ejection fraction using 3-dimensional echocardiography with a full matrix-array transducer: comparison with magnetic resonance imaging. J Am Soc Echocardiogr,2005,18(8): 779-788.
32. Sugeng L, Mor-Avi V, Weinert L, et al. Quantitative assessment of left ventricular size and function: side-by-side comparison of real-time three-dimensional echocardiography and computed tomography with magnetic resonance reference.Circulation,2006, 114 (7):654-661.
33. Jacobs LD, Salgo IS, Goonewardena S, et al. Rapid online quantification of left ventricular volume from real-time three-dimensional echocardiographic data. Eur Heart J, 2006,27(4):460-468.
34. Qin JX, Jones M, Shiota T, et al.Validation of real-time three-dimensional echocardiography for quantifying left ventricular volumes in the presence of a left ventriular aneurysm: in vitro and in vivo studies.J Am Coll Cardiol,2000,36 (3) :900-907.
35. Schmidt MA, Freidlin RZ, Ohazama CJ, et al. Anatomic validation of a novel method for left ventricular volume and mass measurements with use of real-time 3-dmensional echocardiography. J am Soc Echocardiog,2001,14(1): 1-10.
36. Lee D, Fuisz AR, Fan PH,et al. Real-time 3-dimensional echocardiographic evaluation of left ventricular volume: correlation with magnetic resonance imaging--a validation study. J Am Soc Echocardiogr,2001,14(10):1001-1009.
37. Prakash K, Li X, Hejmadi A,et al. Determination of asymmetric cavity volumes using real-time three-dimensional echocardiography: an in vitro balloon model study.Echocardiography,2004,21(3):257-263.
38. Yao GH, Li F, Zhang C,et al. How many planes are required to get an accurate and timesaving measurement of left ventricular volume and function by real-time three-dimensional echocardiography in acute myocardial infarction? Ultrasound Med Biol,2007,33(10): 1572-1578.
39. Arai K, Hozumi T, Matsumura Y, et al. Accuracy of measurement of left ventricular volume and ejection fraction by new real-time three-dimensional echocardiography in patients with wall motion abnormalities secondary to myocardial infarction. Am J Cardiol,2004,94(5):552-558.
40. Devereux RB, Alonso DR, Lutas EM, et al. Echocardiographic assessment of left ventricular hypertrophy:comparison to necropsy findings. Am J Cardiol,1986,57 (6) :450-458.
41. Paczek A, Gardin JM, Hardin JM,et al.Comparison of M-mode and two-dimensional echocardiographic algorithms used to estimate left ventricular mass: the Coronary Artery Risk Development in Young Adults Study.J Am Soc Echocardiogr,1995, 8 (6):780-792.
42. Gopal AS, Keller AM, Shen Z, et al. Three-dimensional echocardiography: in vitro and in vivo validation of left ventricular mass and comparison with conventional echocardiographic methods. J Am Coll Cardiol,1994,24(2):504-513.
43. Devereux RB, Pini R, Aurigemma GP, et al.Measurement of left ventricular mass:methodology and expertise. J Hypertens,1997,15(8):801-809.
44. Rodevand O, Bjornerheim R, Kolbjornsen O, et al. Left ventricular mass assessed by three-dimensional echocardiography using rotational acquisition. Clin Cardiol., 1997,20(11):957-962.
45. Mor-Avi V, Sugeng L, Weinert L, et al. Fast measurement of left ventricular mass with real-time threedimensional echocardiography: comparison with magnetic resonance imaging. Circulation,2004,110(13): 1814-1818.
46. Caiani EG, Corsi C, Sugeng L, et al. Improved quantification of left ventricular mass based on endocardial and epicardial surface detection with real time three dimensional echocardiography. Heart ,2006,92(2):213-219.
47. van den Bosch AE, Robbers-Visser D, Krenning BJ, et al. Comparison of real-time three-dimensional echocardiography to magnetic resonance imaging for assessment of left ventricular mass. Am J Cardiol ,2006,97(1): 113-117.
48. Qin J X, Shiota T, Thomas JD. Determination of loft ventricular volume,ejection fraction,and myocardial mass by real-time three-dimensional echocardiography.Echocatdiogmphy, 2000,17(8):781-786.
49. Jenkins C, Bricknell K, Hanekom L, et al. Reproducibility and accuracy of echocardiographic measurements of left ventricular parameters using real-time three-dimensional echocardiography.J Am Coll Cardiol,2004,44(4):878-886.
50. Oe H, Hozumi T, Arai K, et al.Comparison of accurate measurement of left ventricular mass in patients with hypertrophied hearts by real-time three -dimensional echocar-diography versus magnetic resonance imaging.Am J Cardiol,2005,95 (10) : 1263-1267.
51. Qin JX, Jones M. Travaglini A, et al. The accuracy of left ventricular mass determined by real-time three-dimensional echocardiography in chronic animal and clinical studies: a comparison with post mortem examination and magnetic resonance imaging.J Am Soc Echocardiogr,2005,18(10):1037-1043.
52. Zhuang L, Xie MX, Wang WJ, et al. Quantitative assessment of myocardial perfusion defects with real-time three-dimensional myocardial contrast echocardiography. Chin Med SciJ,2006,21(3):135-139.
53. Sapin SM, Gopal AS, Clarke GB, et al. Three-dimensional echocardiography compared to two-dimensional echocardiography for measurement of left ventricular mass anatomic validation in an open chest canine model. Am J Hypertens,1996,9(5):467-474.
54. Camarano G, JonesM, Freidlin RZ, et al. Quantitative assessment of ventricular perfusion defects using real-time three-dimensionalmyocardial contrast echocardiography. J Am Soc Fxhocardiogr, 2002,15 (3): 206-213.
55. Lowes BD,Gill EA,Abraham WT,et al.Effects of carvedilol on left ventricular mass,chamber geometry ,and mitral regurgitation in chronic heart failure.Am J Cardiol., 1999,83(8):1201-1205.
56．张瑞芳，秦石成．心力衰竭患者左心室非同步运动对左心功能、心肌重构影响的超声 研究．中国超声医学杂志，2006，22(5)：344-346．
57.Lamas GA,Vaughan DE,Parisi AF,et al.Effects of left ventricular shape and captopril therapy on exercise capacity after anterior wall acute myocardial infarction.Am J Cardiol,1989,63(17):1167-1173.
58.Mannaerts HF,van der Heide JA,Kamp O,et al.Early identification of left ventricular remodeling after myocardial infarction,assessed by transthoracic 3D echocardiography.Eur Heart J,2004,25(8):680-687.
59.Li F,Chen,YG,Yao G H,et al.Usefulness of left ventricular conic index measured by real-time three-dimensional echocardiography to predict left ventricular remodeling after acute myocardial infarction.Am J Cardiol,2008,102(11):1433-1437.
60.De Castro S,Caselli S,Maron M,et al.Left ventricular remodelling index(LVRI)in various pathophysiological conditions:a real-time three-dimensional echocardiographic study.Heart,2007,93(2):205-209.
61.De Castro S,Pelliccia A,Caselli S,et al.Remodelling of the left ventricle in athlete's heart:a three dimensional echocardiographic and magnetic resonance imaging study.Heart,2006,92(7):975-976.
62．周永昌，郭万学主编．超声医学．第5版．北京：科学技术文献出版社，2007．：445-451．
63.Grossman W.Diastolic dysfuncion and congestive heart failure.Circulation,1990,81(2Suppl):Ⅲ1-7.
64.Zeidan Z,Erbel R,Barkhausen J,et al.Analysis of global systolic and diastolic left ventricular performance using volume-time curves by real-time three-dimensional echocardiography.J Am Soc Echocardiogr,2003,16(1):29-37.
65.Nguyen LD,Leger C.Four dimensional reconstruction of the left ventricle using a fast rotating classical phased array scan head:preliminary results.J Am Soc Echocardiogr,2002,15(6):593-600.
66.Zeidan Z,Buck T,Barkhausen J,et al.Real-time three-dimensional echocardiography for improved evaluation of diastolic function using volume-time curves.Herz,2002,27(3):237-245.
67.Clements IP.Combined systolic and diastolic dysfunction in the presence of preserved left ventricular ejection fraction.European Journal of Heart Failure.,2005,7(4):490-497.
68.Higuchi T,Taki J,Nakajima K,et al.Left ventricular ejection and filling rate measurement based on the automatic edge detection method of ECG-gated blood pool singlephoton emission tomography.Ann Nucl Med,2004,18(6):507-511.
69．郭薇，陈斌，陈德伟．等．实时三维超声心动图左室容积-时间曲线定量分析缺血心肌 的临床意义．中国超声医学杂志，2006，22(4)：273-275．
70．李秀昌，张运，张梅，等．正常人左室心肌节段局部三维容量和收缩功能的定量研究．中国超声医学杂志，2004，20，(2)：102-105
71.Collins M,Hsieh A,Ohazama C J,et al.Assessment of regional wall motion abnormalities with real-time 3-dimensional echocardiography.J AmSoc Echocardiogr,1999,12(1):7-14.
72.Matsumura Y,Hozumi T,Arai K,et al.Non-invasive assessment of myocardial ischaemia using new real-time three-dimensional dobutamine stress echocardiography:comparison with conventional two-dimensional methods.Eur Heart J,2005,26(16):1625-1632.
73.Aggeli C,Giannopoulos G,Misovoulos P,et al.Real-time three-dimensional dobutamine stress echocardiography for coronary artery disease diagnosis:validation with coronary angiography.Heart,2007,93(6):672-675.
74.Nemes A,Geleijnse ML,Krenning BJ,et al.Usefulness of ultrasound contrast agent to improve image quality during real-time three-dimensional stress echocardiography.Am J Cardiol,2007,99(2):275-278.
75.Krenning B J,Nemes A,Soliman OI,et al.Contrast-enhanced three-dimensional dobutamine stress echocardiography:between Scylla and Charybdis?Eur J Echocardiogr,2008,9(6):757-760.
76.Cohn JN.Structural basis for heart failure.Ventricular remodeling and its pharmacological inhibition.Circulation,1995,91(10):2573-2581.
77．任文武，华琦，李康，等．冠状动脉病变与左室功能关系的临床观察．中国医学影 像技术，200l，17(6)：534-536．
78.Holmes DR Jr,Detre KM,Williams DO,et al.Long-tree outcome of patients with depressed left ventricular function undergoing percutaneous transluminal coronary angioplasty:the NHLBI PTCA Registry.Circulation,1993,87(1):21-29.
79.Qin JX,Shiota T,McCarthy PM,et al.Real-time three-dimensional echocardiographic study of left ventricular function after infarct exclusion surgery for ischemic cardiomyopathy.Circulation,2000,102(19 Suppl 3):Ⅲ101-106.