斑点追踪技术对左束支起搏与希氏束起搏患者心肌收缩应变及同步性的评价  

Evaluation of myocardial systolic function and synchrony in the patients with permanent left bundle branch pacing and His bundle pacing using ultrasound speckle tracking imaging

作　　者：刘锦源[1] 雍永宏[2] 吴红平[2] 单其俊[2] 常青 张艳娟[2] 李明霞 季玲[2] LIU Jinyuan;YONG Yonghong;WU Hongping;SHAN Qijun;CHANG Qing;ZHANG Yanjuan;LI Mingxia;JI Ling(Department of Cardio-thoracic Surgery,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China;Department of Cardiology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学第一附属医院心胸外科,江苏南京210029 [2]南京医科大学第一附属医院心内科,江苏南京210029

出　　处：《南京医科大学学报（自然科学版）》2023年第2期243-248,共6页Journal of Nanjing Medical University(Natural Sciences)

基　　金：江苏省高等学校自然科学重大项目(21KJB320003);江苏省卫健委科研项目(Z2019021,BJ20014)。

摘　　要：目的:应用斑点追踪成像技术对左束支起搏(left bundle branch pacing,LBBP)与希氏束起搏(His bundle pacing,HBP)患者起搏器植入1年后左心室收缩功能及同步性进行评价。方法:获取LBBP患者(40例)、HBP患者(40例)、对照组(40例)标准心尖四腔、三腔、两腔和短轴二尖瓣、心尖水平图像;分别测量和比较LBBP、HBP患者与对照组纵向、圆周和径向应变、纵向应变达峰时间弥散度(peak strain dispersion,PSD)、左室扭转、心室间机械延迟时间(interventricular mechanical delay time,IVMD);计算和比较圆周应变达峰时间标准差(standard deviation of time to peak circumferential strain,T-sd-CS)、径向应变达峰时间标准差(standard deviation of time to peak radial strain,T-sd-RS)。结果:HBP组短轴心尖平面T-sd-CS大于对照组,其余心室电活动及机械同步性参数与对照组无显著差异;LBBP组QRS波宽度大于HBP组和对照组(P<0.05);LBBP组短轴心尖平面T-sd-CS大于HBP组和对照组(P<0.05);LBBP组左室纵向PSD大于HBP组和对照组(P<0.05);各组间左心室短轴径向应变、T-sd-RS、纵向应变、扭转角度及IVMD比较均无统计学差异。结论:LBBP组与HBP组、对照组相比,左心室内同步性稍延迟;LBBP组与HBP组、对照组心肌收缩功能基本相近。Objective:We aimed to evaluate myocardial systolic function and synchrony in the patients with permanent left bundle branch pacing(LBBP)and His bundle pacing(HBP)one year after operation by ultrasound speckle tracking imaging.Methods:Myocardial imaging of 40 patients with LBBP,40 patients with HBP and 40 control subjects were collected.Regional peak systolic strain in longitudinal,radial,circumferential motion,time to peak circumferential strain,time to peak radial strain,peak strain dispersion(PSD),twist,and interventricular mechanical delay time(IVMD)were measured respectively.Standard deviation of time to peak circumferential strain(T-sd-CS)and standard deviation of time to peak radial strain(T-sd-RS)were calculated.The data was compared and analyzed among three groups.Results:The T-sd-CS of the HBP group in apical plane was larger than that of the control group,there were no significant differences between the HBP and control groups in other parameters.The QRS width of the LBBP group was longer than those of the HBP and control groups(P<0.05).The T-sd-CS of the LBBP group in the apical plane was larger than that of the HBP and control groups(P<0.05).The PSD of the LBBP group was larger than that of the HBP and control groups(P<0.05).There were no significantly differences in radial strain,T-sd-RS,longitudinal strain,twist and IVMD among all groups.Conclusion:Compared with the HBP and control groups,the LBBP group had slightly delayed left ventricular synchronization,and myocardial systolic functions were basically similar in the three groups.

关 键 词：超声心动描记术 应变 应变达峰时间弥散度 左束支起搏 希氏束起搏 

分 类 号：R540.45[医药卫生—心血管疾病]