二维斑点追踪成像与实时三维超声心动图评价不同部位起搏器植入术后左心室收缩功能与同步性

发布时间：2018-02-20 07:16

本文关键词： 心脏起搏器人工超声心动描记术斑点追踪成像超声心动描记术三维心室功能左　出处：《中国医学影像学杂志》2017年11期 　论文类型：期刊论文

【摘要】：目的应用二维斑点追踪成像(2D-STI)及实时三维超声心动图(RT-3DE)评价右心室不同部位起搏器植入术后左心室收缩功能及同步性,并研究两种技术的一致性。资料与方法收集2016年9月-2017年5月于重庆医科大学附属第二医院行永久性心脏双腔起搏器植入术的患者27例,并根据起搏器植入部位不同分为右心室心尖部(RVA)起搏组及右心室流出道(RVOT)起搏组。分别于术前及术后1个月采用2D-STI和RT-3DE获取患者的左心室射血分数(LVEF)、纵向应变及同步性参数,并分析同步性参数左心室18节段达峰时间的标准差(Tp-SD)与左心室16节段达最小收缩末期容积时间的标准差占心动周期的百分比(Tmsv-16-SD%)的相关性。结果两组术后LVEF较术前显著减低(P0.05)。RVA组术后左心室心尖段纵向收缩期峰值应变较术前明显增大(P0.05)。两组术后左心室收缩同步性参数均较术前明显升高(P0.05),其中RVA组较RVOT组增大更为显著,Tp-SD、左心室18节段达峰时间的最大差、左心室16节段达最小收缩期容积时间的最大差、左心室16节段达最小收缩期容积时间最大差占心动周期的百分比差异有统计学意义(P0.05)。同步性参数Tp-SD与Tmsv-16-SD%参数呈显著正相关(r=0.775,P0.001)。结论两组术后左心室收缩功能均较术前减低。RVA组及RVOT组术后均引起左心室收缩不同步,但RVOT组左心室收缩同步性优于RVA组。2D-STI和RT-3DE均可定量评价左心室收缩同步性,且一致性较好。
[Abstract]:Objective to evaluate the left ventricular systolic function and synchronism after pacemaker implantation in different parts of the right ventricle by using 2D dot-tracking imaging (2D-STI) and real-time three-dimensional echocardiography (RT-3DEE). Data and methods from September 2016 to May 2017, 27 patients underwent permanent double chamber pacemaker implantation in the second affiliated Hospital of Chongqing Medical University. The patients were divided into right ventricular apex pacing group and right ventricular outflow tract pacing group according to different sites of pacemaker implantation. Left ventricular ejection fraction (LVEF), longitudinal strain and synchronization parameters were obtained by 2D-STI and RT-3DE before and 1 month after implantation, respectively. The correlation between the standard deviation of 18 segment peak time of left ventricle (Tp-SD) and the percentage of left ventricular minimum end-systolic volume time (LV16) in cardiac cycle was analyzed. Results LVEF after operation in both groups was higher than that before operation. The peak longitudinal systolic strain of left ventricular apical segment was significantly increased in the RVA group than in the preoperation group. The synchronous parameters of left ventricular contraction in the two groups were significantly higher than those in the preoperative group, especially in the RVA group compared with the RVOT group. The left ventricular systolic synchrony was significantly increased in the RVA group than in the RVOT group, and the left ventricular systolic synchronicity was significantly increased in the RVA group than in the RVOT group. The maximum difference of peak time in 18 sections of room, Left ventricular 16 segments reach the maximum difference of minimum systolic volume time, There was significant difference in the percentage of minimum systolic volume time difference between 16 segments of left ventricle and cardiac cycle (P 0.05). There was a significant positive correlation between synchronous parameters Tp-SD and Tmsv-16-SD% parameters. Conclusion the left ventricular systolic function in the two groups after operation is higher than that in the operation group. The left ventricular contraction was out of sync after operation in both anterior reduction group and RVOT group. But left ventricular systolic synchrony in RVOT group was better than that in RVA group. 2D-STI and RT-3DE could quantitatively evaluate left ventricular systolic synchrony, and the consistency was good.
【作者单位】：重庆医科大学超声影像学研究所;重庆医科大学附属第二医院超声科;重庆市超声分子影像重点实验室;
【基金】：国家自然科学基金(81501482)
【分类号】：R540.45;R541.7

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