二维斑点追踪成像评价QRS时限对射血分数正常的左束支传导阻滞患者左心室功能及同步性的影响  

Effect of QRS duration on left ventricular function and synchrony in complete left bundle branch block patients with preserved left ventricle ejection fraction using two-dimensional speckle tracking echocardiography

作　　者：李光源[1] 马春燕[1] 王永槐[1] 李阳[1] 关正宇[1] 金炫佚[1] 杨军[1] 

机构地区：[1]中国医科大学附属第一医院心血管超声科,辽宁沈阳110001

出　　处：《中国医学影像技术》2017年第3期325-329,共5页Chinese Journal of Medical Imaging Technology

基　　金：国家自然科学基金(81401413)

摘　　要：目的探讨二维斑点追踪成像(STE)评估左心室射血分数(LVEF)正常的完全性左束支传导阻滞(CLBBB)患者不同QRS时限下左心室收缩、舒张功能及同步性的价值。方法收集LVEF正常的CLBBB患者44例,根据QRS时限分为宽QRS组(QRS>150ms)和窄QRS组(120ms≤QRS≤150ms);另选30名健康体检者作为对照组。对各组均行常规超声心动图及STE检查。测量并计算左心室整体、室间隔、左心室侧壁纵向峰值应变(LS-G、LS-Sept、LS-Lat)、左心室18节段心肌纵向应变达峰时间的标准差(SDt)及左心室舒张功能指标(EDT、E/A、E/e')等。结果宽QRS组和窄QRS组SDt均大于对照组(P均<0.01),宽QRS组SDt大于窄QRS组(P<0.05)。宽QRS组LVEF和LS-G均小于对照组和窄QRS组(P均<0.05),窄QRS组与对照组间差异无统计学意义(P均>0.05)。宽QRS组和窄QRS组LS-Sept均小于对照组(P均<0.01),宽QRS组LS-Sept小于窄QRS组(P<0.01)。窄QRS组LS-Lat大于对照组和宽QRS组(P均<0.05),宽QRS组与对照组间差异无统计学意义(P>0.05)。宽QRS组和窄QRS组的E/A和EDT均小于对照组(P均<0.05),E/e'大于对照组(P均<0.05);宽QRS组与窄QRS组间,EDT、E/A、E/e'差异均无统计学意义(P均>0.05)。结论宽QRS的LVEF正常的CLBBB患者左心室收缩、舒张功能及收缩同步性减低,而窄QRS患者左心室收缩功能无明显减低。Objective To evaluate the value of twc^dimensional speckle tracking echocardiography （2D-STE） in assessing left ventricular systolic function, diastolic function and synchrony with different QRS complex duration in complete left bundle branch block （CLBBB） patients with preserved left ventricle ejection fraction （LVEF）. Methods A total of 44 patients with CLBBB and LVEF≥50 %were included. All the patients were divided into two groups based on QRS duration, QRS〉150 ms as wide QRS group and 120 ms≤QRS≤150 ms as narrow QRS group. And 30 healthy people were included as control group. Two-dimensional echocardiography and 2D-STE were performed. Left ventricle longitudinal peak stain of global, septum and free wall （LS-G, LS- Sept, LS-Lat）, standard deviation of time to peak systolic strain for the 18 left ventricular segments （SDt） and index of left ven- tricular diastolic function （EDT, E/A and E/e） were measured. Results SDt values of wide QRS group and narrow QRS group were significantly higher than that of control group （both P〈0.01）. And SDt of wide QRS group was significantly higher than that of narrow QRS group （P〈0.05）. LVEF and LS-G in wide QRS group were significantly lower than those in both narrow QRS group and control group （all P〈0. 05）, while there was no significant difference between narrow QRS group and control group （all P〉0.05）. The LS-Sept in wide QRS group and narrow QRS group were both lower than that of control group （both P 〈0.01）. And LS-Sept in wide QRS group was lower than that of narrow QRS group （P〈0. 01）. LS-Lat in narrow QRS group was separately higher than those of both wide QRS group and control group （both P〈0.05）, while there was no significant difference of LS-Lat between wide QRS group and control group （P〉0.05）. Compared with control group, E/A and EDT decreased and of E/e increased in both wide QRS group and narrow QRS group （all P〈0.05）. While there was no significant difference between wide QR

关 键 词：束支传导阻滞 QRS时限 心室功能 左 超声心动描记术 应变 

分 类 号：R541[医药卫生—心血管疾病] R540.45[医药卫生—内科学]