速度向量成像评价右室不同部位起搏对左心房收缩功能及同步性的影响  

Evaluation of the Effects of Different Pacing Site of Right Ventricle on Left Atrial Systolic Function and Synchronization by Velocity Vector Imaging

作　　者：唐琳梅 李明星 叶强 冯健 王文渊 梁杉 夏纪筑 Tang Linmei;Li Mingxing;Ye Qiang;Feng Jian;Wang Wenyuan;Liang Shan;Xia Jizhu(Department of Ultrasound*the Affiliated Hospital of Southwest Medical University,Luzhou,Sichuan 646000,China)

机构地区：[1]西南医科大学附属医院超声科,四川省泸州市646000 [2]西南医科大学附属医院心内科,四川省泸州市646000

出　　处：《中国超声医学杂志》2020年第1期37-39,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的利用速度向量成像(VVI)评价右心室心尖部起搏(RVAP)和流出道起搏(RVOP)对左心房收缩功能及同步性的影响。方法分析57例起搏器植入术后2年的患者及35例正常人的心尖四腔心二维图像,得到左房峰值应变(Ss)、舒张晚期峰值应变(Sa)、收缩期应变率(s-SR)、舒张晚期应变率(a-SR),以及收缩期、舒张晚期应变达峰时间标准差(SDs、SDa)。结果与对照组比较,起搏器组的Ss、s-SR、a-SR减低,SDs、SDa增大(P<0.05),Sa两组间差异无统计学意义;流出道起搏组的Ss、s-SR、a-SR均大于心尖部起搏组(P<0.05);RVOP组术后2年SDs、SDa小于RVAP组(P<0.05)。结论持续RVOP和RVAP均可导致缓慢性心律失常患者左房储器功能及泵功能减低,收缩运动失同步化,但RVOP的不良影响较小,VVI可以灵敏地发现起搏器患者的左房功能变化。Objective To evaluate the effects of right ventricular apex pacing(RVAP)and outflow tract pacing(RVOP)on left atrial systolic function and synchronization by velocity vector imaging(VVI).Methods The apical four-chamber two-dimensional image of 57 patients with implanted pacemaker after 2 years and 35 normal subjects were analyzed.Obtain the left atrial peak strain(Ss),late diastolic peak strain(Sa),left atrial systolic strain rate(sSR)and late diastolic strain rate(a-SR).The standard deviation of the strain time to peak(SDs,SDa)were calculated respectively.Results Compared with the control group,Ss,s-SR and a-SR were reduced,SDs and SDa were increased in the pacemaker group(P<0.05).There was no significant difference in Sa between the two groups.Compared with the right ventricular apex pacing group,Ss,s-SR and a-SR were reduced,SDs and SDa were increased in the RVOP group(P<0.05).Conclusions In patients with bradyarrhythmia,RVOP and RVAP can lead to left atrial reservoir function and pump function damaged and left atrial contraction dyssynchronized,but RVOP reduces the unfavourable effects.Velocity vector imaging can sensitively detect changes in left atrial function in pacemaker patients.

关 键 词：速度向量成像技术 心脏起搏器 同步性 心房功能 

分 类 号：R540.45[医药卫生—心血管疾病] R541.7[医药卫生—内科学]