缺血性心肌病患者心房同步性的超声评价  

Assessment of atrial synchronicity in patients with ischemic cardiomyopath

作　　者：杨丽翠[1,2] 林加锋[3] 王凯华[1,2] 林苗[1,2] 

机构地区：[1]温州医科大学定理临床学院 [2]温州市中心医院心血管内科,浙江温州325000 [3]温州医科大学附属第二医院心血管内科,浙江温州325027

出　　处：《温州医学院学报》2013年第8期512-514,共3页Journal of Wenzhou Medical College

基　　金：温州市科技局科研基金资助项目(Y20130056)

摘　　要：目的:应用定量组织速度成像技术(QTVI)评价缺血性心肌病(ICM)伴完全性左束支传导阻滞(CLBBB)患者心房内和心房间电机械收缩的同步性。方法:选择32例ICM伴CLBBB心衰患者(ICM组)、30例CLBBB射血分数正常且无心衰症状者(对照组),于心尖四腔观测量左房游离壁、房间隔及右房游离壁取样点处P波起始点至QTVI曲线上的A波起始点的时限P-LA、P-IAS、P-RA。左房内同步性定义为P-LA与PIAS的差值(T1),左右房间的同步性定义为P-LA与P-RA的差值(T2)。结果:与对照组相比,ICM组中P-LA、P-IAS、P-RA明显延长(P<0.01),T1、T2明显增大(P<0.01)。线性相关分析发现左心房内运动不同步与左房大小及血清氨基末端利钠肽前体(NT-proBNP)浓度密切相关。结论:ICM伴CLBBB患者存在左心房内及左右心房间不同步运动,且与左心房增大、NT-proBNP浓度关系密切。Objective： To assess the intra-and inter-atrial synchronicity in patients with ischemic cardiomyopathy （ICM） accompanied with complete left bundle branch block （CLBBB） by quantitative tissue velocity imaging （QTVI）. Methods： Thirty-two patients with ICM and CLBBB （ICM group）, thirty patients with normal left ventricular ejection fraction （LVEF） and CLBBB （the control group） were selected. To assess atrial synchronicity, myocardial velocity curves were reconstituted off-line using the left atrial （LA） free wall, the inter-atrial septum （IAS）, and the right atrial （RA） free wall. The difference of time from the onset of the P wave to the onset of the A wave at LA （P-LA）, IAS （P-IAS）, and RA （P-RA） were measured. Intra-atrial asynchrony was defined as the difference between P-LA and P-IAS （LA asynchrony T1）. Inter-atrial asynchrony was defined as the difference between P-LA and P-RA （T2）. Results： P-LA, P-IAS were significantly longer in patients with ICM than that in control group （P〈0.01）. Compared with the control group, ICM group had significant LA and inter-atrial asynchrony （P〈0.01）. Left atrial size and NT-proBNP were important factors leading to these asynchronies in the patients with ICM. Conclusion： Intra-atrial （LA） and inter-atrial mechanical asynchrony is significantly delayed in ICM with CLBBB patients. Left atrial size and NT-proBNP are important factors leading to these asynchronies in the patients with ICM.

关 键 词：定量组织速度成像技术 心房 同步性 缺血性心肌病 完全性左束支传导阻滞 

分 类 号：R54[医药卫生—心血管疾病]