二维斑点追踪检测的左心室扭转预测心脏再同步化治疗的短期疗效

 目的探讨超声二维斑点追踪（STE）检测的左心室扭转参数预测心脏再同步化治疗（CRT）短期疗效的价值。方法接受CRT治疗的心衰患者34例，在术前3 d及术后1个月采用STE检测左心室基底和心尖峰值旋转角度（Rot-Ba 和Rot-Ap）、基底和心尖达峰值旋转角度时间（T-Ba 和T-Ap）、基底和心尖达峰时间差（Ba-Ap Rot Delay）、左心室峰值扭转角度（Ptw）和达峰时间（TPtw）、左心室标化峰值扭转角度（Ptor）。将术后左室收缩末容积（LVESV）减小率△LVESV≥15%定义为CRT短期治疗有效。结果21 例（61.8%）患者为CRT 短期治疗有效组（R 组）。术前R 组Rot-Ba、Rot-Ap、Ptw 和Ptor 大于无效组（NR 组），Ba-Ap
Rot Delay 短于NR 组，其余参数无差异。术后与NR组比较，R 组的Rot-Ba、Rot-Ap、Ptw 和Ptor 增大，Ba-Ap Rot Delay 缩短。Rot-Ap、Ptw 和Ptor 是△LVESV≥15%的独立影响因素，Ptw跃2.2毅预测CRT 短期治疗有效的敏感性和特异性分别为78%和74%。结论STE 检测的左心室扭转参数可准确预测CRT 短期疗效。

Prediction of Short-term Response to Cardiac Resynchronization Therapy by Left Ventricular Twist Using Two-dimensional Speckle Tracking Echocardiography

Objective To evaluate the value of left ventricular(LV) twist assessed by two-dimensional speckle-tracking echocardiography(STE) in predicting the short-term response to cardiac resynchronization therapy(CRT).Methods 34 heart failure patients scheduled for CRT were included.STE was performed before and one month after the pacemaker implantation to assess the LV peak apical and basal rotation degrees(Rot-Ap and Rot-Ba),time intervals between apical and basal rotations(Ba-Ap Rot Delay),peak twist(Ptw),and pea...