超声组织同步显像技术评价双腔起搏器治疗房室传导阻滞患者的心肌收缩同步性  

Evaluation on Myocardial Systolic Synchrony in Patients with Atrial-ventricular Block after Dual-chamber Pacemaker Therapy by Tissue Synchronization Imaging Technique

作　　者：刘丽[1] 夏稻子[1] 李阳[1] 周海霞[1] 

机构地区：[1]大连医科大学附属第二医院超声科,辽宁省大连市116027

出　　处：《中国超声医学杂志》2012年第3期240-242,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的应用组织同步显像技术(TSI)评价起搏器治疗房室传导阻滞(A-V block)患者的疗效。方法采集28例A-V block患者起搏器治疗前后的心尖四腔心、心尖二腔及心尖左室长轴的QRS距左室各节段收缩期及舒张早期速度峰值时间(Tp)、峰值速度(Vp),并计算12节段收缩期及舒张早期峰值时间标准差(Ts-SD、Td-SD)。Simpson双平面法测左室射血分数(EF),左室收缩末容积(LVESV)及舒张末容积(LVEDV)。比较Ts与TSI指数的相关性。结果心脏起搏器治疗后左室射血分数(LVEF),心率(HR)显著增加(P<0.05);QRS距左室各节段收缩期及舒张早期峰值时间标准差(Ts-SD)、(Td-SD)显著降低(P<0.05);左室舒张末容积(LVEDV)及左室收缩末容积(LVESV)、TSI指数显著降低(P<0.05);Ts值的变化与TSI指数的变化呈显著相关(r=0.74,P<0.05)。结论 TSI指数作为半定量心室的机械不同步性的新参数,对评价A-V block患者心脏同步起搏治疗的疗效方面有较大的应用价值。Objective Tissue synchronization imaging techniques （TSI）were used to evaluated on myocardial sys- tolic synchrony of atrial-ventricular block （A-V block） patients after pacemaker therapy. Methods We collected 28 cases of tissue Doppler images including apical four-chamber plane, Apical two-chamber plane, Apical long-axis plane of left ventricle in patients with A-V block before and after pacemaker-therapy. We obtained the QRS peak time（Tp） and peak velocity（Vp） of systolic and early diastolic phase, then calculated the Ts and Td standard deviations of 12 segements of each cases. The ejection fraction（EF）, end systolic and diastolic volume （ESV.EDV） of left ventricle also were recorded at the same time. We compared the relationship between Ts and TSI index. Results The significantly increasing of LVEF and HR （P〈0.05） and decreasing of Ts-SD,Td-SD（P〈0.05） ;decreasing of LVEDV, LVESV, TSI（P〈0.05） can be seen after the pacemaker therapy. An obvious correlation existed between Ts and TSI index（r= 0. 74,P〈0. 05）. Conclusions The TSI index as new parameter of semi-quantitative index of mechanical ventricular asynchrony has a great value on evaluating the curative effect of A-V block after pacemaker therapy.

关 键 词：超声心动描记术 多普勒 心脏起搏器 房室传导阻滞 组织同步显像技术 

分 类 号：R541.7[医药卫生—心血管疾病] R445.1[医药卫生—内科学]