速度向量成像对显性预激综合征左室旁道标测的临床价值

目的探讨速度向量成像（velocity vector imaging,VVI）技术标测显性预激综合征左室旁道位置的临床价值。方法健康组20例,A型显性预激综合征患者15例,均行体表12导联同步心电图及超声心动图检查,排外器质性心脏病及室内传导阻滞。以VVI技术测量正常组及对照组射频消融术前、术后左室短轴二尖瓣环及乳头肌水平收缩早中期心肌运动速度达峰时间（TV）,记录局部心肌速度达峰时间标准差（T-SD）、心室最早与最迟达峰心肌间的时间延迟（T-MX）,进行旁道标测及同步化分析,以心内电生理为金指标,评价VVI对旁道标测的准确率。结果 （1）正常组心脏收缩同步协调,速度向量长短和方向基本一致。（2）对照组收缩早期心肌收缩不协调,向量大小和方向不一致,VVI显示局部心肌出现提前收缩的向心性速度向量,TV较其他节段心肌明显提前,T-SD、T-MX与正常组比较有明显差异（P〈0.05）。15例患者行心内电生理检查证实,14例与VVI标测结果基本一致并行射频消融术,术后心肌向量大小和方向基本一致,有1例VVI未能判断出旁道位置,术后证实旁道来源于右室后底部。结论VVI技术能够对A型显性预激综合征左室旁道进行较准确的标测。

Clinical value of velocity vector imaging in displaying the left accessory pathways of patients with overt pre-excitation syndrome

Objective To assess the clinical application value of VVI in locating left accessory pathways of patients with overt pre-excitation syndrome. Methods Setting up a control group consisted of twenty healthy volunteers and a trial group consisted of fifteen patients with type A overt pre-excitation syndrome diagnosed by ECG. They were examined by VVI .Then we compared the index of VVI with intraeardiac electrophysiological examination. Results （1） In the control group, healthy volunteers＇ heart con- traction was synchronous. The magnitude and directions of velocity vector are accordant： （2） In the trial group, Fourteen patients＇ results of VVI and intracardiac electrophysiological examination were the same. Magnitude and directions of myocardium are accordant basically after performed RFCA. In addition, one ease can not be displayed by VVI. According the operation we know that accessory pathway derived from posterior septum close to right ventricle. Conclusion VVI can display type A overt pre-excitation syndrome derivbd from left accessory pathways exactly.