The evaluation of post-infarction ventricular septal rupture and the risk factors of death by left ventricular opacification and real-time three-dimensional echocardiography / 中华超声影像学杂志
Chinese Journal of Ultrasonography
; (12): 933-939, 2019.
Article
em Zh
| WPRIM
| ID: wpr-824434
Biblioteca responsável:
WPRO
ABSTRACT
Objective To study the local morphology of post-infarction ventricular septal rupture (PI-VSR) and the left ventricular function before and after operation and to evaluate the relevant risk factors of death in patients with PI-VSR by using left ventricular opacification (LVO) combined with real-time three-dimensional echocardiography (RT-3DE).Methods Twenty-eight patients with PI-VSR and 19 patients undergoing surgical treatment were selected.The consistency of two-dimensional ultrasound,RT-3DE and the detection of LVO on the maximum diameter,location,number and shape of ventricular septal rupture (VSR) with the surgical results were compared.Through LVO combined with RT-3DE,the changes of left ventricular function indexes before and after surgery were compared.According to the general data and clinical data of patients,independent risk factors affecting survival and prognosis were explored.Results ①There was no significant difference between LVO and RT-3DE in detecting VSR maximum diameter and surgical results (all P >0.05).The location,number and shape of VSR detected by LVO were consistent with the surgical results (all P <0.05).RT-3DE had good consistency in detecting VSR location,shape and surgical results (all P <0.05).Among them,of LVO's detection of VSR location and shape and the Kappa values of consistence of the intraoperative results were 0.650 and 0.883 respectively.LVO had a sensitivity of 0.923,specificity of 1.000,accuracy of 0.947,positive predictive value of 1.000 and negative predictive value of 0.857 in observing VSR shape.② LVO combined with RT-3DE was used to evaluate the left ventricular function of postoperative patients.The parameters of left ventricular function improved significantly(all P <0.05).③The independent risk factors affecting the 30 d survival rate includedgender,Killips pump function classification,and whether or not surgery was performed.Conclusions LVO and RT-3DE can provide more accurate anatomical information such as VSR maximum diameter,location,number and shape,which provides the basis for the selection of treatment strategy.LVO combined with RT-3DE can evaluate the changes of left ventricular function before and after surgery,which can provide reference for clinical evaluation of prognosis.
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Índice:
WPRIM
Tipo de estudo:
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Idioma:
Zh
Revista:
Chinese Journal of Ultrasonography
Ano de publicação:
2019
Tipo de documento:
Article