实时三维超声心动图评价Ⅲ度房室传导阻滞患者植入起搏器后左心室节段收缩同步性  

Evaluation of left ventricular systolic synchrony in patients with Ⅲ grade atrio-ventricular block after pacemaker implantation by real-time three-dimensional echocardiography

作　　者：潘翠珍[1] 舒先红[1] 宿燕刚[2] 俞霏[2] 葛均波[2] 

机构地区：[1]复旦大学附属中山医院上海市心血管病研究所心超室,上海200032 [2]复旦大学附属中山医院上海市心血管病研究所心内科,上海200032

出　　处：《中华超声影像学杂志》2010年第1期1-4,共4页Chinese Journal of Ultrasonography

基　　金：国家自然科学基金（C0303101）

摘　　要：目的探讨实时三维超声心动图17节段时间-容积曲线参数在评价Ⅲ度房室传导阻滞患者植入起搏器后左室收缩同步性的远期疗效。方法对12例植入VVI模式起搏器的Ⅲ度房室传导阻滞患者、7例植入DDD模式起搏器的Ⅲ度房室传导阻滞患者及20例正常对照者进行实时三维超声心动图检查。结果①Ⅲ度房室传导阻滞患者植入DDD模式、VVI模式的时间-位移参数指标——位移平均值、位移标准差、位移最大值与正常对照组比较差异无统计学意义（P〉0．05），而DDD模式、VVI模式的位移最小值较正常对照组低，差异有统计学意义（均P〈0．05）。而从2个“牛眼图”可以直观显示Ⅲ度房室传导阻滞患者植入DDD模式、VVI模式左室部分节段收缩延迟或收缩提早，及部分节段收缩活动减弱或反向运动，而正常对照组未出现收缩不同步及收缩活动减弱。②Ⅲ度房室传导阻滞起搏器植入患者DDD模式、VVI模式的17节段时间-容积曲线参数指标——左室16节段、12节段、6节段达最小收缩容积的时间各自的经心动周期的校正值标准差（Tmsv 16-SD、Tmsv 12-SD Tmsv 6-SD）、最大差值（Tmsv 16-Dif、Tmsv 12-Dif、Tmsv 6Dif）及[Tmsv16-SD（％）、Tmsv12-SD（Voo）、Tmsv6-SD（％）、Tmsv16-Dif（Voo）、Tmsv12-Dif（％）、Tmsv6-Dif（％）]与正常对照组比较，差别均有统计学意义（P〈0．05）。结论实时三维超声心动图能快速评价Ⅲ度房室传导阻滞起搏器植入患者心脏节段收缩功能及节段收缩同步性。Objective To evaluate left ventricular systolic synchrony in patients with Ⅲ grade atrioventricular block（ Ⅲ grade AVB） after pacemaker implantation by real-time three-dimensional echocardiograpby. Methods Methods Twelve patients with Ⅲ grade AVB implanted by VVI pacemaker, seven patients with Ⅲ grade AVB implanted by DDD pacemaker, twenty subjects with normal LV function were examined by Philips iE33 with a X3-1 probe. Results The minimal excursion in patients with Ⅲ grade AVB implanted by VVI pacemaker and DDD pacemaker was less than that in subjects with normal LV function （ P 〈0.05） ,and two ＂bull eyes＂ displayed that some regional systolic timing delayed or ahead, but also some regional systolic excursion hypokinesis or dykinesis. Parameter index [including Tmsv 16-SD, Tmsv 12-SD, Tmsv 6-SD, Tmsv 16-Dif, Tmsv 12-Dif,Tmsv 6-Dif,Tmsv 16 SD（%）,Tmsv 12-SD（%）,Tmsv 6 SD（%）,Tmsv 16-Dif（%）,Tmsv 12-Dif（%）, Tmsv 6-Dif（%） ] of 17 segment time to minimal systolic volume in patients with m grade AVB implanted by VVI pacemaker and DDD pacemaker was more than that in subjects with normal LV function （all P 〈 0. （}5）. Conclusions Real-time three-dimensional echocardiography can rapidly evaluate left ventrieular systolic synchrony in patients with Ⅲ grade AVB implanted by DDD pacemaker and VVI pacemaker.

关 键 词：超声心动描记术 实时三维 心脏传导阻滞 心脏起搏 人工 心室功能 左 

分 类 号：R445.1[医药卫生—影像医学与核医学]