心脏再同步化治疗中期患者关闭左心室起搏对左室血液流场及收缩功能的影响

发布时间：2018-09-06 06:22

【摘要】：目的应用血流向量成像(VFM)技术评价心脏再同步化治疗(CRT)中期患者三腔起搏与关闭左室起搏后的两腔起搏左室收缩期血液流场演变以及收缩功能变化情况。方法 CRT术后6~12个月有反应的患者17例,关闭左心室起搏,分别于三腔和两腔起搏时行常规超声心动图检查。利用VFM软件采集左室内血流向量图像,观察其演变特征。结果与三腔起搏比较,关闭左心室起搏器30min后患者的MRV增多,LVDp/Dtmax降低,IVC时长延长(均P0.05);据VFM观测三腔起搏状态时主动脉开放瞬间PH更靠近左室后侧壁、PL更靠近基底部、Vmax增加,IVC-△PH增大,涡流观测终点VA、FA均较两腔起搏时小,以上参数(均P0.05)。结论关闭左心室起搏器会对部分常规超声心动图参数及VFM参数产生不良影响,即三腔起搏状态较两腔起搏状态能够更好的辅助左心腔做功。VFM技术能够客观有效地反映关闭左心室起搏后左室收缩期血液流场的变化。
[Abstract]:Objective to evaluate the evolution of left ventricular systolic blood flow field and the changes of systolic function in two-chamber pacing after three-chamber pacing and two-chamber left ventricular pacing in patients with cardiac resynchronization in the middle stage of (CRT) by using flow vector imaging (VFM) technique. Methods left ventricular pacing was closed in 17 patients from 6 to 12 months after CRT. Routine echocardiography was performed in three chamber pacing and two chamber pacing. The image of left ventricular blood flow vector was collected by VFM software, and its evolution was observed. Results compared with three-chamber pacing, The increase of MRV in patients with left ventricular pacemaker (30min) after the closure of left ventricular pacemaker (LVDp / Dtmax) decreased the duration of IVC (P0.05), according to the VFM observation, the PH was closer to the left ventricular posterior wall and the left ventricular posterior wall was closer to the left ventricular posterior wall, and the Vmax was increased, according to the VFM observation, the left ventricular posterior wall was closer to the left ventricular posterior wall and the Vmax was increased. The end point VA,FA of eddy current observation was smaller than that of two-chamber pacing (P0.05). Conclusion turning off the left ventricular pacemaker has adverse effects on some conventional echocardiographic parameters and VFM parameters. That is, the three-chamber pacing state is better than the two-chamber pacing state in assisting left ventricular work. VFM can objectively and effectively reflect the changes of left ventricular systolic blood flow field after left ventricular pacing closure.
【作者单位】：宁夏医科大学总医院心脏中心功能检查部超声心动图;第四军医大学西京医院超声诊断科;第四军医大学西京医院心脏内科导管室;
【基金】：国家自然科学基金(No.81170305) 军队基金(No.CWSIIJ056) 2012年陕西省科技计划项目(No.2012K15-02-03)
【分类号】：R540.45;R541

【参考文献】