组织多普勒评价右室不同部位起搏对左室机械运动同步性的影响  

Evaluation of Left Ventricular Synchrony in Patients with Different Selective Site Pacing by Tissue Doppler Imaging

作　　者：俞杉[1] 吴强[1] 卜婕[1] 安亚平[1] 陈亚宁[1] 

机构地区：[1]贵州省人民医院心内科,贵阳市550002

出　　处：《中国超声医学杂志》2014年第6期516-519,共4页Chinese Journal of Ultrasound in Medicine

基　　金：贵州省优秀科技教育人才省长资金项目(No.201212)

摘　　要：目的采用组织多普勒技术(TDI)定量评价右室心尖部(RVA)及间隔部(RVS)起搏对左室收缩与舒张机械运动同步性的影响。方法将65例房室传导阻滞具备埋藏式心脏起搏器植入适应证患者,分为右室心尖(RVA)起搏组(RVA组,29例)和右室流出道间隔(RVS)起搏组(RVS组,36例),于术前、术后1、3、6个月及12个月采用TDI技术分别测量左室各室壁基底段和中段心肌收缩达峰时间(Ts)及舒张早期速度达峰时间(Te),计算12节段收缩速度达峰时间标准差(Ts-SD)和舒张早期速度达峰时间标准差(Te-SD)。结果 RVS组术后6个月和12个月多数心肌节段的Ts和术后3、6个月及12个月的Te-SD均比RVA组相同时点缩短(P<0.05)。结论应用TDI定量评价心室同步性,RVS起搏可较RVA更有利于保持左室心肌收缩和舒张的同步性,可能是更为理想的右室起搏部位。Objective To compare the effects of right ventricular apex pacing （RVA） and right ventricular septum pacing （RVS） on left ventricular synchrony by tissue Doppler imaging （TDI）.Methods RVA pacing was conducted in 29 patients with atrioventricular block （RVA group,n =29） and RVS pacing in 36 patients （RVS group,n =36）.On the first month,3rd month,6th month and 12th month after pacemaker implantation,the time to peak myocardial systolic velocity during ejection phase （Ts） and the time to peak myocardial early diastolic velocity （Te） in 12 left ventricular segments of patients were evaluated by TDI,from which the standard deviation of Ts and Te in the 12 segments （Ts-SD/Te-SD） were calculated.Results Compared with RVA group,RVS pacing significantly shortened Ts in most myocardial segments on the 6th month and 12th month after pacemaker implantation.Te-SD in RVS group were significantly shorter on the 3rd month,6th month and 12th month after implantation than that in RVA group.Conclusions RVS pacing fulfill a more physiological depolarization pattern and be good for keeping the left ventricular systolic and diastolic synchrony.

关 键 词：组织多普勒成像 起搏部位 同步性 

分 类 号：R541.7[医药卫生—心血管疾病]