二维斑点追踪显像技术评价右室心尖部起搏对病态窦房结综合征患者左房功能的短期影响

目的：探讨二维斑点追踪显像（2DSTI）技术检测病态窦房结综合征（ SSS）患者右室心尖部起搏（ RVAP）后短期内左房功能指标的变化。方法30例病态窦房结综合征（ SSS）且不合并房室结病变的患者作为研究对象，所有患者均行双腔起搏器植入术。其中心房电极置于右心耳，心室电极置于右室心尖。所有患者均于RVAP前及术后1h行常规行超声心动图（ UCG）检查并运用STI技术获取左房功能各项指标。结果术后左房收缩期应变峰值（Ss）、收缩期应变率峰值（SRs）、舒张早期应变率（SRe）和舒张晚期应变率（SRa）较术前显著降低，差异均有统计学意义（ P＜0．01）。结论 SSS患者RVPA后短期内左房储器、管道及辅泵功能同时受损，STI技术可用于评价SSS患者RVPA对左房功能的短期影响。

Short-term Effects of Right Ventricular Apical Pacing with Two-dimensional Speckle Tracking Imaging on the Left Atrium Function in Patients with Sick Sinus Syndrome

Objective To explore the short-term changes of the left atrium function in patients with sick si-nus syndrome （ SSS ） after right ventricular apical pacing （ RVAP ） using two-dimensional speckle tracking imaging （2DSTI）.Methods Thirty patients with SSS and intact intrinsic atrioventricular conduction were included.All patients received dual-chamber pacemaker implants with the atrial lead in the right atrial appendage and the ventricular lead in the right ventricular（ RV） apex.Transthoracic echocardiography and 2DSTI were performed to identify functional changes in the left atrium（LA）before and after 1 hour of RVAP.Results Peak systolic LA strain（Ss）,mean peak systolic LA strain rate（ SRs） ,peak early diastolic LA strain rate（ SRe） ,and peak late diastolic LA strain rate（ SRa） were significant-ly reduced after RVAP（P〈0.01）.Conclusion RVPA lead to reservoir,conduit,and contractile function of LA im-paired in patients with sick sinus syndrome in the short term,the speckle tracking imaging（ STI） can be used to evaluate the short-term changes of the left atrium function in patients with sick sinus syndrome after right ventricular apical pa-cing.