摘要
目的应用斑点跟踪显像(speckle tracking imaging,STI)技术评价心脏起搏和右束支传导阻滞(RBBB)的左心室旋转角度异常,初步揭示心室激动顺序异常时左心室心肌力学变化规律。方法应用STI技术对13例安置起搏器者,12例RBBB者和13例正常健康者胸骨旁左心室心尖、乳头肌和基底短轴观的心肌旋转角度进行定量分析。结果①各节段基底与心尖水平旋转角度之差的绝对值在不同组呈现递减趋势。②在正常组内,下后壁和后间隔心尖与乳头肌水平的旋转角度差值比大于基底与乳头肌水平的旋转角度差值比(P=0.01);RBBB组,下壁和后间隔心尖水平差值比大于基底水平(P<0.05);起搏组内,侧壁和后壁心尖水平差值比大于基底水平(P<0.05)。结论STI技术是评价心室整体收缩功能的新方法,心脏起搏和RBBB状态下左心室收缩期室壁旋转角度的异常改变是左心室血流动力学状态异常变化的力学基础之一。
Objective To assess abnormality of left ventricular torsion（LVtor） with cardiac pacing and right bundle branch block （RBBB） patients by two-dimensional ultrasound speckle tracking imaging （STI）, and demonstrate the rule of LV myocardium dynam during abnormal ventricular mechanical activation. Methods Thirteen patients with cardiac pacing, twelve patients with RBBB and thirteen healthy people underwent the examination of two-dimensional ultrasound, then the standard LV basal, middle and apical short-axis views were acquired. The torsion angle were measured and calculated along the segments of inter-ventricular septum, anterior, lateral, posterior and inferior wall of LV at the basal, middle and apical level using a dedicated two-dimension strain software. LVtor was defined as the net difference of LVtor at the basal and apical planes. LVtor odds ratio was difined as the difference of LVtor at the basal/apical and middle plane,s divide by LVtor at middle planes. Results ① Compared with normal group, LVtor odds decreased in pacing group at the segments of anterior inter-ventricular septum and anterior wall（ P 〈0. （15）, and decreased obviosly in RBBB group at anterior, lateral, posterior and inferior during systole period（ P 〈0.05）. ② LVtor odds rartio of septum in normal apical plane was bigger than that of basal plane at posterior, inferior and posterior inter-ventricular group （P = 0.（11 ）, at inferior and posterior interventricular septum in RBBB group （ P 〈0.（15）, at lateral and posterior in pacing group （ P 〈 0. （15）. Conclusions LVtor odds and LVtor odds rartio were novel indices for assessment of global LV systolic function base on the two-dimensional echocardiographic gray-scale images. The results confirmed an asynchronism of LV mechanical activation in patients with pacing group and RBBB group, which reflected on abnormal LV torsional deformation was one of the base of abnormal hemodynamic changes of LV with cardiac pacing and RBBB.
出处
《中华超声影像学杂志》
CSCD
2006年第9期641-645,共5页
Chinese Journal of Ultrasonography
