DDD模式起搏器植入患者左心室心肌收缩同步性和整体收缩功能的实时三维超声心动图研究  

Assessment of the left ventricular systolic synchronization and global systolic function in patients with implantation of DDD mode cardiac pacemakers by real-time three-dimensional echocardiography

作　　者：张连仲[1] 刘琳[1] 张娜[1] 王山岭[1] 周晗[1] 范闽延[1] 边晓琳[1] 

机构地区：[1]河南省人民医院超声科,郑州450003

出　　处：《中华超声影像学杂志》2009年第4期291-293,共3页Chinese Journal of Ultrasonography

基　　金：基金项目：河南省医学科技攻关项目（200703094）

摘　　要：目的探讨实时三维超声心动图技术评价房室顺序双心腔起搏、感知触发和抑制型（DDD）模式起搏器植入患者左室心肌收缩同步性和整体收缩功能的价值。方法应用实时三维超声心动图对20例DDD模式起搏器植入患者和20例正常人进行左室心肌收缩同步性和整体收缩功能检测，得到左心室舒张末期容积（LEDV）、收缩末期容积（LESV）、每搏量（SV）、射血分数（LVEF）、17节段心电图QRS波起始点至左心室最小容积点时间的平均值（Tmean）及其标准差（T—SD）、17节段心电图QRS波起始点至左心室最小容积点时间的最大差值（Tmax）。结果与对照组相比，病例组LESV增大，LVEF、SV减小，T—SD、Tmax延长，差异均有统计学意义（P〈0．01）；两组LEDV、Tmean差异均无统计学意义（P〉0．05）；病例组中LVEF与T—SD、Tmax呈负相关（r分别为-0．674和-0．634，P〈0．05）。结论DDD模式起搏器植入患者存在一定程度的左室心肌收缩失同步和整体收缩功能减退，应用实时三维超声心动图可对其进行定量评价。Objective To assess the left ventricular synchronization and global systolic function in patients with implanted dual-chamber （DDD） mode cardiac pacemakers by real-time three-dimensional echocardiography（RT-3DE）. Methods Left ventricular systolic synchronization and global function were evaluated in 20 patients with implanted DDD mode cardiac pacemakers and 20 normal people by RT-3DE. The left ventricular end-diastolic volume （LEDV）, end-systolic volume （LESV）, stroke volume （SV）, left ventricular ejection fraction （LVEF）, the mean value of time from the start of electrocardiographic QRS wave to the point of minimal systolic volume （Tmean） of the 17 segments and those standard deviation（T- SD）,the maximal difference of time among all 17 segments（Tmax） were obtained by RT-3DE. Results Compared with control group, LESV was significantly increased, SV, LVEF were significantly decreased and T-SD,Tmax were significantly prolonged（ P〈0.01 ）. There were no differences in LEDV and Tmean between the two groups （ P 〉0.05）. In patients group,LVEF correlated closely with T-SD （ r = - 0. 674, P 〈 0.05） and Tmax （ r = - 0. 634, P〈 0.05）. Conclusions There were left ventricular systolic asychronization and global systolic dysfunction in patients with implanted dual-chamber （DDD） mode cardiac pacemakers, which could be assessed by RT-3DE.

关 键 词：超声心动描记术  实时三维 心脏起搏  人工 心肌收缩 心室功能  左 

分 类 号：R686[医药卫生—骨科学]