【摘要】 目的探讨超声心动图参数评估左心室射血分数(LVEF)正常老年患者植入双腔起搏器后的左室舒张功能。方法应用斑点追踪、组织多普勒和彩色M型多普勒参数测量40例LVEF正常的植入双腔起搏器右室心尖起搏(RVAP)老年患者(A组)和30例健康体检老年人(C组)的左室收缩和舒张功能;ELISA法检测血浆B型钠尿肽(BNP)水平。随访1年。结果与C组比较,1年后,A组二尖瓣口舒张早期血流峰值/舒张晚期血流峰值、舒张早期二尖瓣环组织运动速度[室间隔侧瓣环峰值速度、外侧瓣环峰值速度及两者平均值(Ea mean)]、整体舒张早期纵向应变率和舒张早期血流播散速度均降低,而QRS波离散度、E/Ea mean和BNP升高,且等容舒张时间延长(P<0.05或P<0.01)。A组多元线性回归模型分析显示,年龄、Ea mean、E/Ea mean与BNP水平独立相关(P<0.05)。结论老年患者植入双腔起搏器后,RVAP加重了左室舒张功能的损害。Ea mean、E/Ea mean参数可作为评估左室舒张功能不全进展的重要指标。更多还原

【Abstract】 Objective To explore the role of echocardiography parameters in evaluation of left ventricular diastolic function in elderly patients with normal left ventricular ejection fraction(LVEF),who were implanted with dual-chamber pacemaker.Methods The parameters of speckle tacking imaging,tissue Doppler imaging and color M-mode Doppler were used to measure left ventricular systolic and diastolic function in 40 elderly patients(group A)with atrial synchronous right ventricular apical pacing(RVAP)and 30 healthy controls(group C).Plasma B-type natriuretic peptide(BNP)was detected by ELISA in two groups.The patients were followed-up for one year.Results Compared to group C after one year,the ratio of early diastolic transmitral inflow velocity to late diastolic transmitral inflow velocity,peak early mitral annular diastolic velocity[at septal wall,at lateral wall and the mean value(Ea mean)],global early diastolic strain rate and early diastolic flow propagation velocity were decreased,but QRS duration,E/Ea mean and BNP were increased,and isovolumetric relaxation time was prolonged(P<0.05 and P<0.01).Multiple linear regression model in group A showed that age,Ea mean and E/Ea mean were the independent factors related to plasma BNP(P<0.05).Conclusion After dual-chamber pacemaker implantation in elderly patients,RVAP increases the damage of left ventricular diastolic function.Ea mean and E/Ea mean can be the important indicators in evaluating left ventricular diastolic dysfunction.更多还原