实时三维超声心动图联合组织多普勒评价右室不同部位起搏患者左心室舒张功能的变化  

The Influence of Different Right Ventricular(RV)Pacing Site on Left Ventricular(LV)Diastolic Function with RT-3DE and TDI

作　　者：彭凌云[1] 刘安康 丁怀胜[1] 王惠[1] 李原[1] 

机构地区：[1]四川省眉山市人民医院心内科,620010

出　　处：《医学理论与实践》2017年第10期1408-1410,共3页The Journal of Medical Theory and Practice

摘　　要：目的:应用实时三维超声心动图(RT-3DE)与组织多普勒成像技术(TDI)联合评价右室心尖部(RVA)及右室中位间隔部(RVMS)起搏对儿童患者左心室舒张功能的影响。方法:入选2008年1月-2015年10月在我院植入VVI单腔起搏器的完全型房室传导阻滞(AVB)儿童患者29例,分为右室心尖部起搏组(RVA组,n=16)和右室中位间隔部起搏组(RVMS组,n=13)。应用实时三维超声心动图技术与组织多普勒成像联合评价两组儿童患者起搏器植入前后的左室舒张功能指标变化。结果:与RVMS组相比,左室射血分数(LVEF)、舒张早期二尖瓣血流频谱峰值(E峰)在RVA组明显降低(P均<0.05)。TDI显示,RVA组患者左室侧壁处二尖瓣环速度峰值(E’峰)降低,舒张晚期峰值(A’峰)、E/E’及Tei指数均升高(P均<0.05)。结论:组织多普勒成像技术与实时三维超声心动图联合检测表明,右室中位间隔部起搏对儿童患者远期心脏舒张功能影响较小。Objective：The aim of this study was to evaluate the influence of right ventricular apical（RVA） and right ventricular middle septum（RVMS） pacing site on left ventricular（LV） diastolic function in children with RT-3DE and TDI.Methods：Selected from January 2008 to October 2008 in our hospital implanted VVI pacemaker single cavity type completely atrioventricular block （AVB） of 29 cases of children patients.Pacing sites were RVA（n=16） and RVMS（n=13）.Echocardiographic assessment was performed before pacemaker implantation and after it.Results：Compared to RVMS pacing,left ventricular ejection fraction（LVEF） and E-wave（Early diastolic peak flow） were lower in the RVA group（P〈0.05）.E＆#39;wave（Mitral Annular Early Diastolic Motion） at the lateral annular tissue Doppler imaging （TDI） were Significantly lower in children paced at the RV apex,but A＆#39;wave（Mitral Annular late Diastolic Motion）,E/E＆#39;ratio and TDI lateral myocardial performance index （Tei index） were increased（P〈0.05）.Conclusion：Of the two sites studied,right ventricular middle septum（RVMS） site prevents pacing induced reduction of LV diastolic function in children.

关 键 词：组织多普勒成像 实时三维超声心动图 起搏器 舒张功能 

分 类 号：R540.4[医药卫生—心血管疾病]