慢性心力衰竭伴左束支传导阻滞患者QRS波宽度与心室机械收缩不同步的关系  

The correlation between QRS duration and mechanical dyssynchrony in patients with congestive heart failure and complete left bundle branch block

作　　者：孙雅萍[1] 史浩颖[1] 刘健[1] 舒先红[2] 陈灏珠[2] 

机构地区：[1]上海交通大学附属第一人民医院,上海200080 [2]上海复旦大学附属中山医院

出　　处：《中华老年心脑血管病杂志》2008年第9期662-664,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：国家自然科学基金(30671999)

摘　　要：目的应用常规超声心动图和组织多普勒评价心室机械不同步,比较不同QRS波宽度的左束支传导阻滞(CLBBB)慢性心力衰竭(心衰)患者机械不同步程度。方法选择心衰伴CLBBB、LVEF<40%的患者51例,根据QRS波宽度分为2组,Ⅰ组:120ms<QRS≤160ms(21例),Ⅱ组:QRS>160ms(30例)。获取常规超声心动图和组织多普勒图像,应用各超声心动图参数评价患者的机械收缩不同步性。结果左心室射血前时间(LVPT)与QRS波宽度显著相关(r=0.56,P<0.01)。Ⅱ组的LVPT显著大于Ⅰ组,左心室12节段收缩速度达峰时间的标准差和左右心室收缩时间差在两组间无统计学差异。结论在心衰伴CLBBB患者中,QRS波宽度与LVPT显著相关,随着QRS波增宽,左心室内不同步程度无进一步增加。Objective To investigate the correlation between the QRS duration and mechanical dyssynchrony in patients with congestive heart failure and complete left bundle branch block （CLBBB）. Methods Fifty-one chronic heart failure patients with CLBBB were studied. The patients were divided into two groups, group Ⅰ with QRS duration 4160 ms and group Ⅱ with QRS duration longer than 160 ms. All the patients underwent conventional echocardiography and tissue Doppler imaging. Results In patients with heart failure and CLBBB, the left ventricular pre-ejection time（LVPT） correlated significantly with QRS duration （r = 0.56,P〈0.01）. The LVPT was significantly longer in group Ⅱ than in group Ⅰ. However, the tissue Doppler-derived parameters Ts-SD,Ts-12 and Ts-sep-lat did not show significant difference between the two groups. Conclusions In patients with congestive heart failure and CLBBB, the QRS duration correlated significantly with left ventricular pre-ejection delay, but not intra-ventricular dyssynchrony.

关 键 词：超声心动描记术 束支传导阻滞 心室功能 左 心力衰竭 充血性 心肌收缩 

分 类 号：R541.6[医药卫生—心血管疾病] R541.7[医药卫生—内科学]