横向应变评价右心室不同部位起搏的同步性  

Evaluation of right ventricular synchronization using transverse strain after selective pacing

作　　者：陈东骊[1] 汤娇娇[1] 陈泗林[1] 林纯莹[1] 刘烈[1] 张黔桓[1] 梁远红[1] 彭湖[2] 

机构地区：[1]广东省心血管病研究所心内科广东省人民医院(广东省医学科学院),广州510080 [2]中山大学附属五院心内科,广东珠海519000

出　　处：《岭南心血管病杂志》2014年第4期453-456,共4页South China Journal of Cardiovascular Diseases

摘　　要：目的通过测量斑点追踪技术在收缩期横向应变的达峰时间,评价不同部位右心室起搏后的机械同步性。方法前瞻性入选植入双腔起搏器患者60例,术前心电图示QRS波群<120 ms,二维斑点追踪示左心室横向应变同步性良好。右心室尖(right ventricular apex,RVA)组30例,右心室电极植于心尖部;右心室流出道(right ventricular outflow tract,RVOT)组30例,右心室电极植于流出道间隔部。术后1周程控心室电极100%起搏,应用二维斑点追踪成像,测量左心室横向应变达峰时间的最大差。结果起搏前,RVA组左心室17节段纵向应变达峰时间的最大差为(25.62±6.75)ms,RVOT组为(24.33±5.87)ms,两组间比较差异无统计学意义(P>0.05)。起搏后,两组17节段纵向应变达峰时间最大差分别为(226.07±34.57)ms、(125.43±30.39)ms,两组间比较差异有统计学意义(P<0.001)。结论横向应变可作为评价起搏后机械同步性优劣的指标之一。Objectives To evaluate right ventricular synchronization after cardiac pacing using transverse peak systolic strain by speckle tracking technology.Methods A total of 60 consecutive patients were prospectively recruited with QRS duration less than 120 ms and well synchronization by transverse strain preoperatively.Patients were enrolled randomly into right ventricular apex （RVA） group with right ventricular lead in apex,and right ventricular outflow tract （RVOT） group with right ventricular lead in outflow tract.Time difference of left ventricle transverse peak systolic strain was measured in one week after surgery by speckle tracking technology.Results At baseline,time difference of 17-segment model of left ventricle transverse systolic strain was （25.62±6.75） ms in RVA group,and （24.33±5.87） ms in RVOT group,there was no statistical difference between the two groups （P〉0.05）.After sustained pacing,time difference in RVA group was （226.07±34.57） ms,and （125.43±30.39） ms in RVOT group,the difference was statistically significant （P〈0.001）.Conclusions Transverse strain can be an option to evaluate synchronization after permanent pacing.

关 键 词：心脏起搏 超声心动图 机械同步性 应变 

分 类 号：R541.7[医药卫生—心血管疾病]