摘要
目的观察行单腔心脏起搏器植入术患者左心室心肌纵向应变(longitudinal strain,LS)、圆周应变(circumferential strain,CS)和径向应变(radial strain,RS)变化,探讨二维斑点追踪技术(two-dimensional speckle tracking imaging,2D-STI)在评估单腔心脏起搏器植入术后患者左心室功能中的价值。方法行单腔心脏起搏器植入术患者19例,其中心房颤动并Ⅲ度房室传导阻滞(atrioventricular block,AVB)患者12例(AVB组),病窦综合征(sick sinus syndrome,SSS)患者7例(SSS组),均植入VVI型起搏器。分别于VVI植入术前及术后1、3、6个月行超声检查,测量左心室舒张末期容积(left ventricular end-diastolic volume,LVEDV)、左心室收缩末期容积(left ventricular end-systolic volume,LVESV)和左室射血分数(left ventricular ejection fraction,LVEF),并应用2D-STI技术测量左心室心肌16节段LS、CS、RS。结果 SSS组VVI植入术后1、3、6个月LVEDV、LVESV、LVEF、LS、CS、RS与术前比较差异均无统计学意义(P>0.05);AVB组VVI植入术后1个月各指标与术前比较差异无统计学意义(P>0.05),术后3个月LVEF[(52.63±4.68)%]、CS[(-10.21±1.94)%]较术前[LVEF(46.09±5.92)%、CS(-9.40±1.88)%]增高(P<0.05),余指标与术前比较差异均无统计学意义(P>0.05);术后6个月,AVB组LVEF[(52.45±4.78)%]、RS[(11.94±2.03)%]较术前[LVEF(46.09±5.92)%、RS(9.02±2.38)%]增加,LVEDV[(182.68±32.62)mL]、LVESV[(132.78±27.38)mL]较术前[LVEDV(225.32±32.60)mL、LVESV(182.43±28.30)mL]下降,LS[(-11.92±1.69)%]、CS[(-11.23±1.87)%]较术前[LS(-8.52±1.82)%、CS(-9.40±1.88)%]绝对值增高,差异均有统计学意义(P<0.05)。结论 VVI植入术后6个月,心房颤动并Ⅲ度AVB患者左心室功能明显改善,SSS患者改善不明显;2D-STI可用于评估心房颤动并Ⅲ度AVB患者VVI植入术后左心室功能。
Objective To evaluate the value of two-dimensional speckle tracking imaging （2D-STI） to assessing the left ventricular function after single chamber pacemaker implantation by observing the left ventricular myocardial longitudinal strain （LS）, circumferential strain （CS） and radial strain （RS）. Methods Nineteen patients including 12 patients with atrial fibrillation and third-degree atrioventricular block （AVB） and 7 patients with sick sinus syndrome （SSS） were implanted single chamber pacemaker （VVI）, and were measured the left ventricular end-diastolic volume （LVEDV）, left ventricular end-systolic volume （LVESV） and left ventricular ejection fraction （LVEF） in 1, 3 and 6 months after operation. The left ventricular myocardial LS, CS, RS were measured by 2D-STI. Results There were no significant differences in LVEDV, LVESV, LVEF, LS, CS and RS in 1, 3 and 6 months after operation in comparison with those before operation in SSS patients （P〉0.05）. There were no significant differences in LVEDV, LVESV, LVEF, LS, CS and RS in 1 month after operation in comparison with those before operation in AVB patients （P〉0.05）.LVEF （（52.63±4.68）%） and CS （（- 10.21±1.94）% ） in 3 months after operation were significantly higher than those before operation in AVB patients （ （46. 09±5. 92 ） %, （-9.40±1. 88）%） （P〈0.05 ）, and there were no significant differences in the other indexes （P〉0.05）. LVEF （（52.45±4.78）%） and RS （（11.94±2.03）%） were significantly higher, LVEDV （（182.68±32.62） mL） and LVESV （（132. 78±27.38） mL） were significantly lower, and the absolute values of LS （ （ -11.92±1.69）±） and CS （ （ -11.23±1.87） % ） were significantly higher in 6 months after operation in comparison with those before operation in AVB patients （RS： （9. 02±2. 38）%, LVEDV： （225.32±32. 60） mL, LVESV： （182.43±28.30） mL, LS： （-8.52±1.82）M, CS： （-9.40±1.88）M） （P〈
出处
《中华实用诊断与治疗杂志》
2016年第5期470-472,共3页
Journal of Chinese Practical Diagnosis and Therapy
关键词
单腔心脏起搏器植入术
二维斑点追踪
左心室功能
Single chamber pacemaker implantation
two-dimensional speckle tracking imaging
left ventricular function
