慢性充血性心力衰竭患者左室运动不同步与右室收缩功能减低的相关性研究  

The associations between right ventricular contractility and left ventricular dyssynchrony in chronic congestive heart failure patients

作　　者：孙欣[1] 徐楠[1] 张红菊[1] 吴伟春[1] 江勇[1] 焦盼晴[1] 兰亭玉[1] 王浩[1] 

机构地区：[1]北京协和医学院中国医学科学院阜外心血管病医院超声科,北京市100037

出　　处：《中国分子心脏病学杂志》2013年第2期449-452,共4页Molecular Cardiology of China

基　　金：中央级公益性科研院所基本科研业务费项目(2012-F16)

摘　　要：目的探讨慢性充血性心力衰竭(心衰)患者左室运动不同步与右室收缩功能减低之间有无相关性。方法 72例心衰患者行二维应变及常规超声检查。测量前间隔与后壁收缩期轴向应变达峰时间差(SPWMD),以SPWMD≥130ms为左室不同步的标准,测量收缩期三尖瓣环位移(TAPSE)等参数。并以TAPSE≤14mm为截值分为右室收缩功能正常组与减低组。结果 22例(30.56%)患者存在右室收缩功能减低,46例(63.90%)患者存在左室内运动不同步。右室收缩功能正常组与减低组间的SPWMD无明显差异(P=0.658),TAPSE与SPWMD之间无明显相关(r=0.136,P=0.255)。结论心衰患者的右室功能减低与左室内机械运动不同步无明显相关。全面评价心功能需要同时定量分析左、右室功能。Objective We sought to understand the relationships between right ventricular （RV） contractility and left ventricular （LV） dyssyn- chrony in chronic congestive heart failure patients. Methods A total of 72 patients with congestive heart ihilure were analyzed by standard and two- dimensional strain echocardiography. Septal to posterior wall mechanical delay （SPWMD） obtained from 2D radial strain, with a 〉 130ms thresh- old indicating LV dyssynchrony. RV function was evaluated using tricuspid annular plane systolic excursion （TAPSE）, with a 〈 14 mm threshold indicating severe RV impairment. Results Significant RV dysfunction was observed in 22 （30.56%） individuals and 46 （63.90%） patients showed LV dyssynchrony. Patients with RV dysfunction had no more LV dyssynchrony compared to those with preserved RV function （P=0.658）. TAPSE had no correlation with SPWMD （r=0.136, P=0.255）. Conclusion RV function and LV dyssynchrony are not associated. Quantitative analysis of RV func- tion is as important as assessing LV dyssynchrony in patients with congestive heart failure.

关 键 词：超声心动描记术 心力衰竭 右心室功能 不同步 

分 类 号：R541.6[医药卫生—心血管疾病]