摘要
目的应用二维斑点追踪(2D-STI)技术评估左束支起搏(LBBP)及右室间隔部起搏(RVP)术后早期左心功能。方法选取于我院行永久心脏起搏器植入术的患者47例,其中LBBP患者26例(LBBP组),RVP患者21例(RVP组),另选同期健康成人20例作为对照组;应用2D-STI技术分析并获取LBBP组、RVP组术后1个月,以及对照组左房被动排空分数(LAEFp)、储存功能期应变(LASr)、管道功能期应变(LAScd)、辅泵功能期应变(LASct),以及左室整体纵向应变(GLS)和心尖两腔心、三腔心、四腔心切面整体纵向应变(GLS-AP2、GLS-AP3、GLS-AP4),并计算左室17节段纵向应变达峰时间标准差(Tp-SD)、达峰时间最大差值(Tp-dif),比较各组上述参数的差异;分析LASr、LAScd及LASct与Tp-SD、Tp-dif的相关性。结果各组LAEFp、LASr及LAScd比较差异均有统计学意义(均P<0.05)。与对照组比较,LBBP组和RVP组LAEFp、LASr均降低,差异均有统计学意义(均P<0.05);与LBBP组和对照组比较,RVP组LAScd降低,差异均有统计学意义(均P<0.05)。各组GLS-AP2、GLS-AP3、GLS-AP4、GLS、Tp-SD及Tp-dif比较差异均有统计学意义(均P<0.05)。与对照组比较,LBBP组和RVP组GLS-AP2、GLS-AP3、GLS-AP4及GLS均降低,差异均有统计学意义(均P<0.05);与LBBP组和对照组比较,RVP组Tp-SD、Tp-dif均增大,差异均有统计学意义(均P<0.05)。LBBP组和RVP组Tp-SD、Tp-dif与LAScd均呈正相关(均P<0.05)。结论应用2D-STI技术可评估心脏起搏器植入术后早期左心功能。与RVP相比,LBBP患者左室同步性更好,有利于保护左房管道功能。
Objective To evaluate early left heart function after left bundle branch pacing(LBBP)and rightventricular septum pacing(RVP)by two-dimensional speckle tracking imaging(2D-STI)technology.Methods Forty-sevenpatients after pacemaker implantation were selected,including 26 cases of LBBP(LBBP group)and 21 cases of RVP(RVPgroup).A total of 20 healthy subjects were enrolled as control group.Left artial emptying fraction passive(LAEFp),left atrialreservoir strain(LASr),left atrial conduit strain(LAScd),left atrial contraction strain(LASct),global longitudinal strain(GLS)and apical two,three and four chamber view global longitudinal strain(GLS-AP2,GLS-AP3,GLS-AP4)were analyzed by 2D-STI 1 month after implantation in LBBP group and RVP group,and control group.Standard deviation of time to peak(Tp-SD)and maximum difference of time to peak(Tp-dif)were calculated.The differences of the above parameters in each group werecompared.The correlation of LASr,LAScd,LASct and Tp-SD,Tp-dif were analyzed.Results There were statisticallysignificant differences in LAEFp,LASr and LAScd in each group(all P<0.05).Compared with the control group,LAEFp andLASr in LBBP group and RVP group were decreased significantly(all P<0.05).Compared with the LBBP group and controlgroup,LAScd in RVP group was decreased(both P<0.05).There were statistically significant differences in GLS-AP2,GLS-AP3,GLS-AP4,GLS,Tp-SD and Tp-dif in each group(all P<0.05).Compared with the control group,GLS-AP2,GLS-AP3,GLS-AP4 and GLS in LBBP group and RVP group were decreased significantly(all P<0.05).Compared with the LBBP groupand control group,Tp-SD and Tp-dif in RVP group were increased significantly(all P<0.05).Tp-SD,Tp-dif were positivelycorrelated with LAScd in LBBP group and RVP group(all P<0.05).Conclusion 2D-STI technology can evaluate the early leftheart function after cardiac pacing.Compared with RVP,LBBP has better left ventricular synchronization,which is conducive tothe protection of left atrial conduit function.
作者
王秀秀
徐敏
严霜霜
熊诗强
熊峰
WANG Xiuxiu;XU Min;YAN Shuangshuang;XIONG Shiqiang;XIONG Feng(Department of Cardiology,the Affiliated Hospital of Southwest Jiaotong University,Chengdu 610031,China)
出处
《临床超声医学杂志》
CSCD
2023年第2期110-115,共6页
Journal of Clinical Ultrasound in Medicine
基金
四川省卫生健康委员会基金项目(20PJ210)。
关键词
超声心动描记术
斑点追踪
二维
左束支起搏
应变
同步性
Echocardiography
Speckle tracking
two-dimensional
Left bundle branch pacing
Strain
Synchronization
作者简介
通讯作者:熊峰,Email:xiong.feng05@163.com。
