双脉冲多普勒超声评价健康人群左右心室机械做功的顺序

发布时间：2018-03-17 18:20

本文选题：心室功能　切入点：超声心动描记术　出处：《中国循环杂志》2017年03期 　论文类型：期刊论文

【摘要】：目的:应用双脉冲多普勒超声心动图技术观察健康人群中左、右心室收缩期及舒张期机械做功的顺序。方法:选取100例健康志愿者,分别取双流出道切面和心尖四腔切面,应用双脉冲多普勒技术在同一心动周期同步记录左心室流出道、右心室流出道血流频谱和左心室流入道、右心室流入道血流频谱,分别测量心电图QRS波群顶点至主动脉、肺动脉、二尖瓣和三尖瓣血流频谱起始的时间间期,计算主动脉和肺动脉血流频谱、二尖瓣和三尖瓣血流频谱起始时间的差值,进而评估左、右心室收缩和舒张机械做功的顺序。结果:48例左心室先于右心室射血,占48%(95%CI:0.38~0.58);46例右心室先于左心室射血,占46%(95%CI:0.36~0.56);6例左、右心室同时射血,占6%(95%CI:0.01~0.11)。96例右心室先于左心室充盈,占96%(95%CI:0.90~0.99);3例左心室先于右心室充盈,占3%(95%CI:0.01~0.08);1例左、右心室同时充盈,占1%(95%CI:0.00~0.05)。结论:健康人群的左、右心室收缩期及舒张期做功顺序,具有一定的规律:收缩期做功顺序因人而异,但舒张期做功顺序,右心室始终在前。根据正常状态下心室间机械做功的顺序优化起搏器程控参数,选择优化舒张期心脏做功顺序,可能是未来心脏再同步治疗(CRT)起搏器参数优化的终点指标。
[Abstract]:Objective: to observe the order of left and right ventricular systolic and diastolic mechanical work in healthy subjects by double pulse Doppler echocardiography. The flow spectrum of left ventricular outflow tract, right ventricular outflow tract, left ventricular inflow tract and right ventricular inflow tract were recorded simultaneously by dual-pulse Doppler technique in the same cardiac cycle. The peak of QRS wave group to aorta were measured respectively. The time interval between the onset of pulmonary artery, mitral and tricuspid flow spectra, the difference between aortic and pulmonary blood flow spectrum, mitral and tricuspid flow spectrum initiation time, and further evaluation of left, Results the order of mechanical work of right ventricular contraction and relaxation. Results: 48 cases of left ventricle ejected before right ventricle, accounting for 48% 95 CI: 0.38% 0.58% and 46 cases of right ventricle before left ventricular ejection, accounting for 4695% I 0.36% 0.56%, 6 cases left, right ventricular simultaneous ejection, accounting for 69 95 CI: 0.01 0. 11% 0.11%. 96 cases of right ventricle filled up in front of left ventricle. 3 cases with left ventricle filling ahead of right ventricle, 3 cases with left ventricle filling before right ventricle, 1 case with left ventricle and 1 case with right ventricle filling at the same time, 1 case with right ventricle filling at the same time. Conclusion: the order of left and right ventricular systolic and diastolic work of healthy people has a certain rule: the order of doing work in systolic period is different from person to person. But the order of diastolic work, right ventricle is always in front. According to the order of mechanical work done between ventricles in normal state, the program control parameters of pacemaker are optimized, and the order of doing work in diastolic heart is optimized. It may be an end point for the optimization of pacemaker parameters in future cardiac resynchronization therapy (CRT).
【作者单位】：北京大学人民医院心脏中心;复旦大学附属中山医院心脏超声诊断科;
【分类号】：R540.45

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