【作者】 邓燕； 尹立雪； 李春梅； 罗安果； 左明良； 李爽； 王珊； 余洋； 王正阳； 孟庆国；

【Author】 Deng Yan Yin Lixue Li Chunmei Luo Anguo Zuo Mingliang Li Shuang Wan Shan Yu Yang Wang Zhengyang Meng Qingguo (Department of Echocardiography and Non-invasive Cardiology,Sichuan Academy of Medical Science & Sichuan Provincial Hospital,Chengdu 610071,China)

【机构】 四川省人民医院心血管超声及心功能科； 四川省人民医院超声心动图室；

【摘要】 目的应用超声斑点跟踪显像技术评价房室顺序起搏及完全性右束支传导阻滞病人左心室收缩功能.方法应用超声斑点跟踪显像技术分别检测房室顺序起搏 AAI 模式病人10例(A 组)、房室顺序起搏 DDD 模式病人10例(B 组)、完全性右束支传导阻滞病人10例(C 组)及正常对照组10例(D 组)的左心室短轴基底段、中段及心尖段16个节段的位移、速度及应变指标与常规超声心动图测量所得左心室射血分数(EF 值)进行相关分析和比较.结果左心室16节段径向速度均值及径向应变均值与 EF 值呈正相关,相关系数分别为:0.491,0.497(P<0.05);左心室 EF 值、收缩期16节段径向位移峰值均数、径向速度峰值均数与径向应变峰值均数在四组间没有统计学差异.收缩期左心室不同节段径向位移、径向速度与径向应变峰值的组间比较结果显示: B 组与 D 组相比,径向位移峰值在左心室下壁基底段(5.11±1.77 VS 8.53±2.96)、间隔基底段(4.00±2.59 VS 7.11±2.28)及间隔心尖段(5.06±1.96 VS 7.79±2.54)降低,径向应变峰值在下壁心尖段(14.69±9.82 VS 34.06±10.48)及间隔心尖段(15.69±11.64 VS 37.20 ±12.28)降低,差异有统计学意义(P<0.05).A 组及 C 组与 D 组相比左心室各个节段的径向位移、径向速度与径向应变峰值均无统计学差异(P>0.05)。C 组内:尖侧壁径向速度较除尖前壁、中段后壁、中段下壁、基底前壁、基底侧壁及基底前间隔外左心室其它节段降低(P<0.05).结论房室顺序起搏 DDD 模式时,左心室下壁及间隔的基底段和心尖段收缩功能降低,而 AAI 模式时左心室节段性收缩功能没有明显改变.完全性右束支传导阻滞时,左心室尖侧壁收缩功能降低。更多还原

【Abstract】 Objective To evaluate left ventricular systolic function in patients with dual-chamber pacing and complete fight bundle branch block by ultrasonic speckle tracking imaging.Methods The left ventricular radial displacement,velocity and strain of 10 patients with single atrial(AAI)pacing (group A),10 patents with dual-chamber(DDD)pacing(group B),10 patients with complete right bundle branch block(group C)and 10 volunteers(group D)was studied at 16 segments respective in basal,mid and apical levels using ultrasonic speckle tracking imaging,and the results were compared with the left ventricular ejection fraction(EF).Results There was no significant intergroup difference in mean of left ventricular peak radial displacement,peak radial velocity,peak radial strain and EF in the four groups(P>0.05).There was a linear correlation between EF and mean of left ventricular peak radial velocity and peak radial strain(r=0.491 and 0.497,both P<0.05).Compared with D group,the peak radial displacement of left ventricular inferior wall at basal(5.11±1.77 VS 8.53±2.96),septum at basal(4.00±2.59 VS 7.11±2.28)and septum at apex(5.06±1.96 VS 7.7±2.54)was decreased, and the peak radial strain of left ventricular inferior wall at apex(14.69±9.82 VS 34.06±10.48)and septum at apex(15.6±11.64 VS 37.20±12.25)was decreased in group B(P<0.05).There was no significant difference in left ventricular peak radial displacement,peak radial velocity,and peak radial strain within group A,group C and group D(P>0.05).In group C,the peak radial velocity of the left ventricular lateral wall at apex was lower than other regions,but not anterior wall at apical and basal, posterior wall at mid,inferior wall at mid,lateral wall and anterior septum at basal(P<0.05). Conclusion In patients with cardiac pacing,the regional left ventricular systolic function of inferior wall at basal and apex was decreased during DDD pacing,and there were no obvious changes of regional left ventricular systolic function during AAI pacing.The regional left ventricular systolic function of the lateral wall at apical was decreased in patients with complete right bundle branch block.更多还原