超声心动图评价左室假腱索与心脏同步性的临床研究  

Clinical value of echocardiography in evaluating cardiac synchronization in patients with left ventricular false tendons

作　　者：杨盼 葛志祥[1] 刘飞[1] 龚明霞[1] 徐敏[1] YANG Pan;GE Zhixiang;LIU Fei;GONG Mingxia;XU Min(Department of Cardiac Function,Changzhou First People’s Hospital,the Third Affiliated Hospital of Soochow University,Changzhou 213003,China)

机构地区：[1]苏州大学附属第三医院常州市第一人民医院心功能科

出　　处：《临床超声医学杂志》2020年第1期6-9,共4页Journal of Clinical Ultrasound in Medicine

基　　金：国家自然科学基金面上项目(81871381);国家自然科学青年基金项目(81701734);常州市卫计委指导项目(WZ201804)

摘　　要：目的应用超声心动图观察左室假腱索(LVFT)患者心脏同步性的改变,探讨LVFT与左室同步性的关系。方法选取经超声心动图确诊为LVFT的患者173例(LVFT组),以及性别、年龄与之匹配的健康志愿者150例(对照组)。二维超声心动图记录LVFT组患者LVFT的大小、连接方式及走行;脉冲多普勒及实时三维超声心动图测量两组左室舒张充盈时间与同步R-R间期的比值(LVDFT/RR)、主动脉射血前时间与肺动脉射血前时间的差值(T2-T1),以及左室16节段达到最小收缩容积时间的标准差(TMSV16-SD),评价左房室间、左右心室间及左室内的同步性。应用多重线性回归分析LVFT形态特点与同步性指标间的相关性。结果 LVFT不同连接方式及走行比较差异均有统计学意义(P=0.01、0.001)。LVFT组左室内同步性指标TMSV16-SD与对照组比较差异有统计学意义(P<0.001),而房室间同步性指标LVDFT/RR及左、右心室间同步性指标T2-T1比较差异均无统计学意义。多重线性回归显示LVFT的连接方式与左室内同步性指标TMSV16-SD独立相关(均P<0.05)。结论 LVFT的连接方式是影响心脏左室内同步性的重要因素,可为临床诊治提供参考。ObjectiveTo explore the changes of cardiac synchronization and the relationship between cardiac synchronization and left ventricular false tendons(LVFT)by echocardiography.MethodsA taotal of 173 patients with LVFT confirmed by echocardiography(LVFT group)and 150 healthy volunteers without LVFT matched by sex and age(control group)were selected.The sizes,connection modes and direction variations of the patient’s LVFT were recorded by two-dimensional echocardiography.The synchronization of left atrioventricular,interventricular and left ventricular in two groups were evaluated with the ratio of left ventricular diastolic filling time to synchronous R-R interval(LVDFT/RR),the difference between time before aortic ejection and time before pulmonary ejection(T2-T1)and the standard deviation of time to minimum systolic volume in left ventricle 16 segments(TMSV16-SD),which all measured by pulse Doppler and real-time three-dimensional echocardiography. Multiple linear regression was used to analyze the correlation between LVFT morphological characteristics and synchronizationindexes.ResultsThere were statistically significant differences in different LVFT connection modes and direction variations(P=0.01,0.001).There was statistically significant difference between LVFT group and control group in left ventricular synchronization index TMSV16-SD(P<0.001),but no statistically significant differences in left atrioventricular synchronization indexLVDFT/RR and interventricularsynchronization indexT2-T1.Multiple linearregression showed that theconnectionmode of LVFT was independently correlated with the left ventricular synchronization index TMSV16-SD(all P<0.05).Conclusion The connection mode of LVFT is animportant factor affecting left ventricular synchronization,which has good clinical reference value.

关 键 词：超声心动描记术 左室假腱索 心脏同步性 

分 类 号：R540.45[医药卫生—心血管疾病]