完全性右束支传导阻滞患者心室机械功能的变化

目的研究完全性右束支传导阻滞(CRBBB)患者心室机械功能的变化。方法选取CRBBB的患者48例为CRBBB组,另选取心电图正常的健康成人42例为正常组。应用脉冲组织多普勒显像技术(PW-TDI)测量CRBBB患者心肌组织的运动速度与时间间期指标以反映其心室机械功能的变化。结果①与正常组比较,CRBBB组右室侧壁基部收缩波峰值速度(Sm)减小、舒张早期波峰值速度(Em)减小、Em/舒张晚期波(A波)峰值速度(Am)减小(13.7±2.53cm/svs17.00±3.10cm/s;12.1±2.06cm/svs21.05±4.23cm/s;0.71±0.38cm/svs1.22±0.65cm/s,P均<0.01),Am无差异(P>0.05);两组间左室基部六个取样点的Sm、Em、Am、Em/Am比较无差异(P均>0.05);②与正常组比较,CRBBB组右室侧壁基部电-机械延迟时间(EMD)和等容舒张时间(IVRT)延长(55±13msvs46±10ms;41±20msvs30±16ms,P<0.05),射血时间(ET)缩短(309±43msvs400±60ms,P<0.05),等容收缩时间(IVRT)与充盈时间(FT)无差异(P均>0.05);两组间左室基部六个取样点的EMD、IVCT、ET、IVRT及FT比较无差异(P均>0.05)。③与正常组比较,CRBBB组右室侧壁基部Tei指数延长(0.56±0.14vs0.43±0.13,P<0.05);两组间左室各取样点的Tei指数无差异(P>0.05)。结论CRBBB患者右室舒缩功能降低,而左室舒缩功能未受影响。

Changes of ventricular function in patients with complete right bundle branch block

Objective To investigate changes of ventricular function in patients with complete right bundle branch block(CRBBB). Methods Systolic and diastolic velocity and time interval were measured by pulsed wave tissue Doppler imaging(PW-TDI)on 48 CRBBB patients without structural heart diseases and 42 normal adults. Results ①Systole peak velocity(Sm), peak velocity of the early relaxation wave(Em), Em/ peak velocity of the later relaxation wave(Am)ratio of the basal segments of right ventricular lateral wall(RVLW) in CRBBB patients significantly decreased compared with those in controls(13.7±2.53 cm/s vs 17.00±3.10 cm/s; 12.1±2.06 cm/s vs 21.05±4.23 cm/s; 0.71±0.38 cm/s vs 1.22±0.65 cm/s ,P<0.01). Am of basic segment of RVLW were similar in two groups(P>0.05); Sm,Em,Am,Em/Am of the basal segments of the left ventricle were also similar in two groups (P>0. 05).②Electromechanical delay(EMD)and isovolumic relaxation time(IVRT)of the basal segments of RVLW in CRBBB were longer than those in controls(55±13 ms vs 46±10 ms; 41±20 ms vs 30±16 ms,P<0.05), Ejection time(ET)of the basal segments of RVLW in CRBBB patients were shorter than those in controls(309±43 ms vs 400±60 ms,P<0.05),while isovolumic contraction time(IVCT) and filling time(FT) were similar in two groups(P>0.05).EMD, IVCT,ET,IVRT,and FT of the basal segments of the left ventricle were not significantly different in two groups(P>0.05). ③Myocardial performance index(Tei)in CRBBB patients was longer than that in controls(0.56±0.14 vs 0.43±0.13,P<0.05).There was no much change for Tei of the basal segments of the left ventricle in two groups(P>0.05). Conclusion CRBBB may have bad effects on mechanical function of right ventricle, but fail to impair systolic and diastolic functions of left ventricle.