二维斑点追踪成像联合组织多普勒成像技术评价左束支起搏术后早期室间同步性  

Evaluation of Interventricular Synchrony of Left Bundle Branch Pacing by Two-Dimensional Speckle Tracking Imaging and Tissue Doppler Imaging Technique

作　　者：王秀秀 熊峰 邓晓奇 王淑珍 严霜霜 谭焜月 张丽娟 WANG Xiuxiu;XIONG Feng;DENG Xiaoqi;WANG Shuzhen;YAN Shuangshuang;TAN Kunyue;ZHANG Lijuan(The Affiliated Hospital of Southwest Jiaotong University,Department of Cardiology of The Third People’s Hospital of Chengdu,Chengdu Institute of Cardiovascular Diseases,Chengdu 610031,Sichuan,China)

机构地区：[1]西南交通大学附属医院成都市第三人民医院心内科成都市心血管病研究所,四川成都610031

出　　处：《心血管病学进展》2022年第1期88-92,共5页Advances in Cardiovascular Diseases

基　　金：四川省卫生健康委员会基金(20PJ210)。

摘　　要：目的采用二维斑点追踪成像联合组织多普勒成像技术对左束支起搏术后早期室间同步性进行评价,比较两种方法评价室间同步性的效果。方法选取2019年5月—2020年5月于成都市第三人民医院心内科行左束支起搏的患者30例作为病例组,行右室流出道起搏的患者24例作为对照组。术后1个月行经胸超声心动图检查,采集至少三个心动周期的心尖四腔切面二维及组织多普勒动态图像,通过二维斑点追踪技术绘制左室侧壁、右室游离壁应变-时间曲线,记录基底段2个节段纵向应变达峰时间;通过组织多普勒技术绘制左室侧壁、右室游离壁基底段速度-时间曲线,记录基底段2个节段收缩速度达峰时间。两种方法均采用两侧室壁基底段达峰时间差值的绝对值作为室间同步性参数。比较两种起搏方式的室间同步性和两种方法的检测结果。结果两组常规超声心动图参数相比较,差异无统计学意义(P>0.05)。两组二维斑点追踪成像法室间同步性参数相比较,差异有统计学意义(P<0.05),组织多普勒成像法室间同步性参数相比较,差异无统计学意义(P>0.05)。两种方法的室间同步性参数存在正相关关系(相关系数0.392,P<0.05)。两种方法对左束支起搏组的室间同步性检测阳性率结果相比差异有统计学意义(P<0.05),而对右室流出道起搏组检测阳性率结果相比差异无统计学意义(P>0.05)。结论左束支起搏术后早期室间同步性优于右室流出道起搏。使用二维斑点追踪技术可对左束支起搏室间同步性做出快速评价,且优于组织多普勒技术。Objective To evaluate interventricular synchronization in patients with left bundle branch pacing(LBBP)by two-dimensional speckle trackingimaging(2D-STI)and tissue Doppler imaging(TDI),and compare the outcomes of interventricular synchronization parameters by two methods.Methods 30 patients with LBBP in Department of Cardiology of The Third People’s Hospital of Chengdu from May 2019 to May 2020 were selected as the case group,and 24 patients with right ventricular outflow tract pacing(RVOTP)in the same period were selected as the control group.One month after operation,transthoracic echocardiography was performed,and two-dimensional and TDI images of apical four chamber view for at least three consecutive cardiac cycles were collected.The strain-time curves of left and right ventricular walls were generated by 2D-STI,and the time to peak(Ts)of longitudinal strain of basal segments were recorded.The velocity-time curves of 2 basal segments of left and right ventricular walls were generated by TDI,and Ts of contraction velocity of 2 basal segments were recorded.The absolute value of the differences between Ts of basal segments of right and left ventricular walls was used as the interventricular synchronization parameter.Interventricular synchronization of two pacing modes and outcomes of two methods were compared.Results There was no significant difference in conventional echocardiographic parameters between the two groups(P>0.05).There was significant difference in ventricular synchronization parameters between the two groups by 2D-STI(P<0.05),and there was no significant difference in ventricular synchronization parameters by TDI(P>0.05).There was a positive correlation between the ventricular synchronization parameters of the two methods(correlation coefficient 0.392,P<0.05).There was significant difference in the positive rate of ventricular synchrony between the two methods in the LBBP group(P<0.05),but there was no significant difference in the positive rate of ventricular synchrony between the two methods

关 键 词：斑点追踪成像 组织多普勒成像 左束支起搏 室间同步性 机械同步性 

分 类 号：R54[医药卫生—心血管疾病]