左心超声造影指标LVESV、LVEF、LVEDV与慢性心力衰竭患者心功能分级的关系及对抗心力衰竭疗效的评估价值OA

Objective To explore the relationship between left heart contrast echocardiography indexes,including left ventricular end-systolic volume(LVESV),left ventricular ejection fraction(LVEF),and left ven-tricular end-diastolic volume(LVEDV),and the grading of cardiac function,as well as their evaluation value for the anti-heart failure effect in patients with chronic heart failure(CHF).Methods A total of 102 patients with CHF were recruited between May 2021 and May 2025.All patients underwent routine ultrasound examination and left-heart contrast echocardiography.The quality of apical images and the detection of special structures obtained by the two examination methods were compared.Based on the cardiac function grading of the New York Heart Associa-tion(NY HA),the patients were classified into three groups:Grade Ⅳ(n=27),Grade Ⅲ(n=40),and GradeⅡ(n=35).The LVESV,LVEF,and LVEDV measured by routine ultrasound and left-heart contrast echocar-diography in these three groups were compared.The relationship between cardiac function grading and LVESV,LVEF,and LVEDV measured by left-heart contrast echocardiography was analyzed using the Spearman coeffi-cient.After 3 months of anti-heart failure treatment,the CHF patients underwent left-heart contrast echocardiogra-phy again.According to the treatment efficacy,they were divided into an ineffective group(n=23)and an effec-tive group(n=79).The difference values of LVESV,LVEF,and LVEDV(ΔLVESV,ΔLVEF,ΔLVEDV)be-fore and after treatment measured by left-heart contrast echocardiography in the two groups were compared.The evaluation value of left-heart contrast echocardiography in assessing the anti-heart failure effect was analyzed us-ing receiver operating characteristic(ROC)curves.Results The quality of apical images obtained through left heart contrast echocardiography was superior to that obtained via routine ultrasound(P＜0.05).The detection rates of apical thrombosis,ventricular aneurysm,and trabecular hyperplasia by left heart contrast echocardiogra-phy were 8.82％,9.80％,and 14.71％respectively,which were higher than those by routine ultrasound(1.96％,3.00％,5.88％;P＜0.05).The LVESV and LVEDV measured by left heart contrast echocardiography were higher than those measured by routine ultrasound,while the LVEF was lower than that measured by routine ultrasound(P＜0.05).There were significant differences in LVESV,LVEF,and LVEDV measured by routine ultrasound and left heart contrast echocardiography among patients with different cardiac function grading(P＜0.05).In the grade Ⅳ group,grade Ⅲ group,and grade Ⅱ group,LVESV and LVEDV gradually decreased,while LVEF gradually increased(P＜0.05).Spearman analysis indicated that the cardiac function grading of patients with CHF was negatively correlated with LVEF and positively correlated with LVESV and LVEDV measured by left heart con-trast echocardiography(P＜0.05).After 3 months of treatment,the changes in LVESV(ΔLVESV),LVEF(ΔLVEF),and LVEDV(ΔLVEDV)in the effective group were higher than those in the ineffective group(P＜0.05).ROC curve analysis showed that the area under the curve(AUC)values of ΔLVESV,ΔLVEF,andΔLVEDV for evaluating the anti-heart failure effect were 0.720,0.976,and 0.696 respectively(P＜0.05).Con-clusions Left heart contrast echocardiography can enhance the quality of apical images and elevate the detection rates of special structures in patients with CHF.The echocardiographic indexes(LVESV,LVEF,LVEDV)are closely associated with cardiac function grading,and ΔLVEF exhibits the best evaluation efficiency for the anti-heart failure effect.This study offers a basis for the accurate grading and individualized treatment of CHF by com-paring left ventricular contrast echocardiography with routine ultrasound and analyzing the difference values of core indexes.