超声评价心室间协同性对左心室解剖结构和功能重构的影响

目的应用超声心动图探讨心室间协同性对心脏解剖结构和功能重构的影响。方法应用QRS起点至主动脉瓣达峰时间（AT）、QRS起点至肺动脉瓣达峰时间（PT）及其差值（dT），射血前期和射血时间及其比值（PEP／ET）等超声指标评价27例右束支传导阻滞（RBBB）、左束支传导阻滞（LBBB）及右心起搏患者的心室间协同性；并以12例正常人作为对照。结果RBBB组dT较其他组均增大，与正常组比较差异有统计学意义（P=0．005），LBBB组与正常组比较差异具有统计学意义（P=0．011）。LBBB组和起搏组左心室PEP／ET值均增高，与正常组比较差异具有统计学意义（P=0．0005，P=0．004）。LBBB组各腔室内径均较其他组大，与正常组比较差异具有统计学意义（P〈0．05）。dT与左心室PEP／ET显著相关，相关系数r=-0．602，P=0．000。结论心室间协同性与左室收缩功能改变存在密切关系。

Effect of interventricular synchrony on left ventricular structure and function remodeling by echocardiography

Objective To assess the effect of interventricular synchrony on left ventricular structure and function remodeling by echocardiography.Methods The interventricular synchrony,which was indicated by AT (the time interval between the beginning of the QRS complex and the peak velocity of arotia valve),PT(the time interval between the beginning of the QRS complex and the peak velocity of pulmonary valve),dT(AT-PT),pre-ejection period(PEP),ejection time(ET) and PEPET,was evaluated in 27 cases of RBBB,LBBB and right ventricular apical pacing patients by echocardiography compared with 12 normal subjects.Results The value of dT increased in RBBB group,showing a significant difference (P= 0.005 ) compared with normal group,LBBB group was significantly different from normal group (P= 0.011 ).The PEPET of left ventricular increased in both LBBB group and pacing group with statistical difference (P= 0.0005 ,P= 0.004 ) compared with normal group.In comparison with all other groups the end-diastolic dimension of LBBB group was found to be more enlarged,futhermore,there was a statistical difference (P <0.05 ) compared with normal group.The comparison between dT and other parameters showed that dT correlated with PEPET of left ventricular with correlation parameter(r= -0.602 ,P= 0.000 ).Conclusions Improvement of LV systolic function was strongly influenced by interventricular asynchrony.