二维斑点追踪成像评价长期右心室心尖部起搏对左心室心肌收缩功能的影响  

Effects of Long-term Right Ventricular Apex Pacing on Left Ventricular Myocardial Systolic Function by Speckle Tracking Echocardiography

作　　者：马春燕[1] 张妍[1] 刘爽[1] 石水梅[2] 杨军[1] 唐力[1] 于波[2] 

机构地区：[1]中国医科大学附属第一医院心血管超声科,沈阳市110001 [2]中国医科大学附属第一医院心内科,沈阳市110001

出　　处：《中国超声医学杂志》2013年第5期419-422,共4页Chinese Journal of Ultrasound in Medicine

基　　金：辽宁省自然科学基金(No.20102280)

摘　　要：目的采用二维斑点追踪成像(STE)检测长期右心室心尖部起搏(RVAP)对左心室(LV)心肌收缩功能的影响。方法行DDDR模式起搏器植入的高度或Ⅲ度房室传导阻滞患者47例,均为RVAP,在术前3d及术后1年采用STE检测左心室收缩同步性指标T_(AS-POST)、左心室射血分数(LVEF)、心肌纵向二维应变(LS)和径向应变(RS)。将T_(AS-POST)≥130 ms定义为左心室收缩不同步。62例年龄和性别匹配的正常人作为对照组。结果术后T_(AS-POST)延长,心肌LS减低,RS则无显著变化。9例患者T_(AS-POST)>130 ms,长期RVAP导致左心室收缩不同步的发生率为19.15%。结论长期RVAP可导致左心室心肌局部纵向收缩功能减低,且收缩同步性下降,STE可以准确评价左心室心肌收缩功能和收缩同步性。Objective To evaluate the effects of long term right ventricular apex pacing （RVAP） on left ventric ular （LV） systolic synehrony and myocardial function by speckle tracking eehocardiography （STE）. Methods 47 pa- tients with high degree or complete atrioventricular clock （AVB） were performed an implantation of pacemaker, and STE was performed before and one year after the pacemaker implantation to assess LV systolic synchrony and myocar- dial peak longitudinal （LS） and radial strain（RS）. An interval ≥130 ms for the absolute difference in time to peak ra- dial strain for the anteroseptal wall versus the posterior wall（TAsFOST） was defined as LV dyssynchrony. In addition, 62 controls matched by age and sex were studied. Results After long-term RVAP, a more dyssynchronous LV con traction was observed, together with impaired LV longitudinal strain. 9 patients had developed LV systolic dyssyn chrony （TAsPOST≥130 ms）. Conclusions Long term RVAP can impair LV longitudinal strain, and induce LV dyssyn- chrony. And STE is a reliable technique for accurate evaluation of LV synchrony and myocardial strain.

关 键 词：二维斑点追踪成像右心室心尖部起搏左心室收缩同步性 心肌收缩功能 

分 类 号：R445.1[医药卫生—影像医学与核医学] R542.2[医药卫生—诊断学]