室间隔闪烁现象对左束支传导阻滞患者左心室功能及收缩同步性的影响  

The effect of septal flash on left ventricular function and systolic synchrony in patients with complete left bundle branch block and preserved left ventricular ejection fraction

作　　者：李光源[1] 孟平平[1] 马春燕[1] 王永槐[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,沈阳110001

出　　处：《中华超声影像学杂志》2018年第2期118-122,共5页Chinese Journal of Ultrasonography

基　　金：国家自然科学基金（81401413）

摘　　要：目的采用二维斑点追踪成像（2D—STI）评价室间隔闪烁现象（SF）对于完全性左束支传导阻滞（CLBBB）患者左心室功能及收缩同步性的影响。方法收集左心室射血分数（LVEF）正常的CLBBB患者60例作为病例组，健康志愿者30例作为对照组。根据2IYSTI是否存在SF，将病例组分为SF组和非SF组（NSF组）。采用2D—STI测量左心室整体峰值纵向应变（LS-G）及左心室18节段纵向应变达峰时间标准差（LV-SDt）。采用常规超声测量左心房内径（LAD）、LVEF、二尖瓣口舒张早期和舒张晚期血流速度（E、A）、E峰减速时间（EDT），采用TDI测量二尖瓣环舒张早期速度（e’），并计算E／A及E／e’。结果①病例组SF发生率为53．3％（32／60）。②SF组LS—G小于对照组及NSF组（均P〈0．05），而对照组与NSF组之间差异无统计学意义（P〉{）J（15）。③与对照组相比，SF组与NSF组LAD及E／e’均增大，E／A及e’均显著减低（P〈0．05），但SF组与非SF组之间以上数据差异均无统计学意义（P〉0．05）。④与对照组相比，SF组及NSF组LV—SDt均增大（P〈0．01），且SF组增大更显著（P〈0．01）。结论LVEF正常的CLBBB患者中SF存在率为53．3％，且存在SF的患者左心室收缩功能及收缩同步性减低更显著。Objective To evaluate the effect of septal flash （SF） on left ventricular function and systolic synchrony in patients with complete left bundle branch block （CLBBB） and preserved left ventricular ejection fraction （LVEF） by two dimensional speckle tracking imaging （2D-STI）. Methods Sixty CLBBB patients with preserved LVEF were selected, and 30 healthy individuals serving as control group. The SF of CLBBB patients were evaluated using 2D-STI, and the CLBBB patients were categorized into two groups （SF group and NSF group） based on the present SF. Conventional echocadiography and 2D- STI were performed for all individuals. Results ①SF was present in 53.3G of CLBBB patients with preserved LVEF and was not present in control group. ②LV longitudinal peak stain of global （LS G） in SF group was lower than those in both control group and NSF group （ P〈0.05）,and there was no significant difference between control group and NSF group （ P 〉0.05）. ③Compared with control group, there were significant increase of left atrial dimension and Mitral E/e〈 and decrease in mitral E/A and mitral e＇ in SF group and NSF group （ P 〈0.05）, while there was no significant difference between SF group and NSF group （ P 〈0.05）. ④There was an increase in standard deviation of time to peak systolic strain for the 18 LV segments （LV-SDt） in SF group and NSF group, and the LV-SDt in SF group was higher than that in NSF group （ P %0.01 ）. Conclusions SF is present in 53.3% of CLBBB patients, patients of CLBBB with SF have lower left ventricular systolic function and systolic synchrony.

关 键 词：超声心动描记术 束支传导阻滞 心室功能 左 室间隔闪烁现象 应变 

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