摘要
目的探讨应用实时三维超声心动图(real-time three-dimensional echocardiography,RT-3DE)评价右室心尖部起搏(right ventricular apex pacing,RVAP)对左室收缩同步性及收缩功能的早期影响。方法 30例双腔起搏器植入(均为RVAP)的患者为病例组,30例正常人为对照组,在术前及术后1周应用RT-3DE采集左心室全容积图像。应用在机Qlab 8.1分析软件,获得左心室整体与16节段容积-时间曲线和比较左心室16、12、6节段自心电图QRS波起点至左心室最小收缩末容积点时间的标准差和最大时间差(即Tmsv16-SD、Tmsv12-SD、Tmsv6-SD、Tmsv16-Dif、Tmsv12-Dif、Tmsv6-Dif)作为左室收缩同步性参数;同时获得左心室舒张末期容积(1eft ventricle end-diastolic volume,LVEDV)、左心室收缩末期容积(1eft ventricular endsystolic volumes,LVESV)、每搏量(stroke volume,SV)、左心室射血分数(1eft ventricular ejection fraction,LVEF)作为左室收缩功能参数。结果与对照组比较,术后1周,病例组左室收缩同步性参数明显延长(P<0.05),左室收缩功能参数差异无统计学意义(P>0.05)。与术前比较,术后1周,病例组左室收缩同步性参数明显延长(P<0.05),左室收缩功能参数差异无统计学意义(P>0.05)。结论 RVAP早期即可导致左心室收缩不同步,且其同步性变化早于收缩功能变化。RT-3DE可客观、准确地评价左室收缩同步性及收缩功能。
Objective To evaluate left ventricular systolic synchrony and systolic function in patients with short- term right ventricular apex pacing( RVAP) by real- time three- dimensional echocardiography( RT-3DE). Methods 30 patients with DDD mode cardiac pacemakers and 30 normal people were evaluated at baseline and 1 week after the operation by RT- 3DE to obtain full volume images,and those images were analyzed by the Qlab 8. 1 software. Parameters including global and 16- segmental volume- time curves( VCTs),dispersion of time from the start of electrocardiographic QRS wave to the point of minimal regional volume for 16,12,and 6 left ventricular segments( Tmsv16- SD,Tmsv12- SD,Tmsv6- SD),maximal difference of time to minimal regional volume for 16,12 and 6 left ventricular segments( Tmsv16- Dif,Tmsv12- Dif,Tmsv6- Dif),and left ventricular end- diastolic volume( LVEDV),left ventricular end- systolic volume( LVESV),stroke volume( SV),left ventricular ejection fraction( LVEF) were measured respectively. Results Compared with control group,1 week after the operation,the left ventricular systolic synchrony parameters including( Tmsv16- SD、Tmsv12- SD,Tmsv6- SD,Tmsv16- Dif,Tmsv12- Dif,Tmsv6- Dif) were significantly prolonged( P < 0. 05),while the left ventricular systolic function parameters including( LVEDV,LVESV,SV,LVEF) were not significantly changed( P > 0. 05). Compared with operation before,1 week after the operation,the left ventricular systolic synchrony parameters including( Tmsv16- SD,Tmsv12- SD,Tmsv6- SD,Tmsv16- Dif,Tmsv12- Dif,Tmsv6- Dif) were significantly prolonged( P <0. 05),while the left ventricular systolic function parameters including( LVEDV,LVESV,SV,LVEF) were not significantly changed( P > 0. 05). Conclusion Short- term RVAP can cause left ventricular dyssynchrony,and the change of systolic synchrony is earlier than the change of systolic function; RT- 3DE is an accurate and objective method to evaluate left ventricular systolic synchrony and systolic function.
出处
《宁夏医科大学学报》
2013年第11期1233-1236,1310,共5页
Journal of Ningxia Medical University
关键词
超声心动描记术
实时三维
右心室心尖部起搏
同步性
心室功能
echocardiography
real-time three-dimensional
right ventricular apex pacing
synchrony
ventricular function
