核素心血池显像对比组织多普勒超声评价心脏再同步化治疗术后右心室的中期反应  

Comparison Between Equilibrium Radionuclide Angiocardiography and Doppler Tissue Imaging in Evaluating Mid-term Response of Right Ventricle After Cardiac Resynchronization Therapy

作　　者：陈雨[1] 王连新 谷阳 林振宇 严山 张喜文[1] CHEN Yu;WANG Lianxin;GU Yang;LIN Zhenyu;YAN Shan;ZHANG Xiwen(Department of Cardiology,Huai＇an First People＇s Hospital,Huai＇an 223300,China)

机构地区：[1]淮安市第一人民医院心内科,江苏淮安223300

出　　处：《中国医学影像学杂志》2018年第11期824-828,830,共6页Chinese Journal of Medical Imaging

摘　　要：目的对比核素心血池显像(ERNA)与组织多普勒超声(TDI)评价慢性心力衰竭(CHF)患者的右心室同步性及心脏再同步化治疗(CRT)术后右心室的中期反应。资料与方法筛选33例CHF患者行CRT治疗,在CRT术前及术后6个月采集TDI和ERNA图像。右心室游离壁、室间隔基底段和中间段收缩期达峰值应变的最大时间差(RV-T)为TDI的不同步参数。标准化的右心室平均相角(RVmPA%)和右心室峰相位标准差(RVPSD%)为ERNA的不同步参数。分析RVmPA%、RVPSD%与RV-T的相关性,比较有反应组(CRT术后左心室收缩末期容积缩小≥15%)与无反应组各指标的差异。结果 33例患者的右心室不同步参数RVmPA%、RVPSD%与RV-T呈中度正相关(r=0.689、0.716,P<0.05)。CRT术后有反应组20例患者的术前RVmPA%、RVPSD%和RVEF分别为(53.60±4.15)%、(14.00±2.41)%和(32.60±3.80)%,明显比无反应组差,差异有统计学意义(P<0.05)。有反应组患者的术后RVmPA%、RVPSD%和RVEF分别为(43.95±6.88)%、(10.40±1.67)%和(36.35±2.60)%,较术前明显改善,差异有统计学意义(P<0.05)。但有反应组患者术前RV-T为(50.10±10.28)ms,与无反应组相比无明显差异,术后亦无明显改善(P>0.05)。结论 ERNA可以检测CHF患者的右心室不同步性。CRT可以改善CHF患者的右心室功能和同步性。Purpose To compare equilibrium radionuclide angiocardiography （ERNA） with tissue Doppler imaging （TDI） in evaluating right ventricular synchrony in patients with chronic heart failure （CHF） and mid-term response of right ventricle after cardiac resynchronization therapy （CRT）. Materials and Methods Thirty-three patients with CHF were selected for CRT treatment, TDI and ERNA images were collected before and 6 months after CRT. The maximum time difference （RV-T） in reaching peak strain during systole among the right ventricular free wall, ventricular septal basal segment and ventricular septal middle segment was asynchronous parameter of TDI. The normalized right ventricular mean phase angle （RVmPA%） and right ventricular phase standard deviation （RVPSD%） were asynchronous parameters of ERNA. The relations between RVmPA%, RVPSD% and RV-T were analyzed, and the difference in the above indexes between response group （left ventricular end-systolic volume after CRT decreased more than 15%） and non-response group was compared Results The right ventricular asynchronous parameters RVmPA%, RVPSD% and RV-T in 33 patients showed moderate positive correlation （r=0.689 and 0.716, P〈0.05）. After CRT, the preoperative RVmPA%, RVPSD% and RVEF of 20 patients in the response group were （53.60±4.15）%, （14.00±2.41）%, and （32.60±3.80）%, respectively; which were significantly worse than those in the non-response group （P〈0.05）. The postoperative RVmPA%, RVPSD%, and RVEF of patients in the response group were （43.95±6.88）%, （10.40±1.67）% and （36.35±2.60）%, respectively; which were significantly improved compared with that before operation （P〈0.05）. However, the preoperative RV-T of patients in the response group was （50.10±10.28） ms, which, compared with the non-response group,showed no evident difference, and no significant improvement was achieved after operation （P〉0.05）. Conclusion For patients with CHF, ERNA can serve to detect ri

关 键 词：心力衰竭 门控血池显像 超声心动描记术 多普勒 心脏起搏 人工 心室功能 右 

分 类 号：R541.6[医药卫生—心血管疾病] R445.5[医药卫生—内科学]