B型预激综合征左心室运动模式评估

发布时间：2018-03-29 09:41

本文选题：B型预激综合征　切入点：斑点追踪成像　出处：《南京医科大学》2017年硕士论文

【摘要】：目的:分析 B 型预激综合征(type B Wolff-Parkinson-White syndrome,B-WPW)患者左心室扭转参数及左心室心肌纵向应变参数,探讨B-WPW患者左心室运动模式的改变。方法:选取B-WPW患者38例,志愿者40例作为对照组,应用二维斑点追踪成像技术(two-dimensional speckle tracking imaging,2D-STI)测量 B-WPW 患者射频消融术前(B-WPW-B组)、术后(B-WPW-A组)以及对照组左心室扭转参数和心肌纵向应变参数;采用双平面Simpson法测量各组左心室舒张末期容积(LVEDV)、收缩末期容积(LVESV)及左心室射血分数(LVEF)。同步测量心电图Ⅱ导联QRS波时限。结果:B-WPW患者左心室扭转角度峰值及左心室心尖部、心底部旋转角度峰值下降,心底部较心尖部明显;心底部旋转角度提前达峰,心底-心尖部旋转角度达峰时间差值延长;左心室心肌整体纵向峰值应变减低;左心室心肌后壁中间段、下壁心尖段、中间段及基底段、室间隔中间段及基底段纵向峰值应变减低;左心室心腔扩大,QRS波时限延长;射频消融术后B-WPW患者左心室扭转参数恢复明显,心肌纵向应变参数恢复较差,两者均低于对照组。结论:B-WPW患者左心室运动模式发生变化,表现为左心室扭转角度峰值及时序的改变,左心室心底-心尖旋转的失同步;左心室心肌整体纵向峰值应变及部分节段室壁纵向峰值应变的改变;射频消融术后近期患者运动模式改善,但未恢复至正常水平。
[Abstract]:Objective: to analyze the left ventricular torsion parameters and left ventricular longitudinal strain parameters in patients with type B Wolff-Parkinson-White syndrome (type B Wolff-Parkinson-White syndrome) and to explore the changes of left ventricular motion pattern in patients with B-WPW. Methods: 38 patients with B-WPW and 40 volunteers were selected as control group. Two-dimensional speckle tracking imaging2D-STI was used to measure the torsion parameters and longitudinal strain parameters of left ventricle in patients with B-WPW before radiofrequency ablation and after radiofrequency ablation. Left ventricular end-diastolic volume (LVEF), end-systolic volume (LVESVV), left ventricular ejection fraction (LVEF) and left ventricular ejection fraction (LVEF) were measured by biplane Simpson. Results the peak value of left ventricular torsion angle and left ventricular apex were measured simultaneously. The peak value of rotation angle at the bottom of the heart decreased, the peak value of the rotation angle in the bottom of the heart was higher than that in the apical part, the peak time difference of the rotation angle between the bottom and the heart was prolonged, the longitudinal peak strain of the whole left ventricular myocardium was decreased. The longitudinal peak strain of left ventricular posterior wall middle segment, inferior wall apical segment, middle segment and basal segment, interventricular septal segment and basal segment decreased, left ventricular cavity enlargement prolonged QRS wave duration. After radiofrequency ablation, the torsion parameters of left ventricle recovered significantly and the longitudinal strain parameters of myocardium recovered worse in B-WPW patients, both of which were lower than those in the control group. The changes of left ventricular torsion angle and timing, the loss of synchronization between left ventricular bottom and apex rotation, the changes of global longitudinal peak strain of left ventricular myocardium and the longitudinal peak strain of some segments of ventricular wall were observed. After radiofrequency ablation, the motility pattern of the patients improved, but did not return to normal level.
【学位授予单位】：南京医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R541.7

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