二维斑点追踪纵向应变评价不同部位右心室起搏患者心脏收缩同步性

目的利用二维斑点追踪超声纵向应变比较不同部位右心室起搏对左心室收缩不同步性的影响。方法有双腔起搏器植入指征的无器质性心脏病变患者共60例,按1:1随机数表法随机分为两组,根据分组结果分别将右心室电极植入右心室流出道间隔部(right ventricular outflow tract septum,RVOTs)及右心室心尖(right ventricular apex,RVA)。术后起搏器程控并保证心室完全起搏后,进行二维斑点超声成像分析,记录左心室收缩时纵向应变达峰时间的最大差(LS-TD)。结果 RVA组左心室收缩时纵向应变最大差大于RVOT组,差异有统计学意义(161.6±43.9)ms vs.(74.3±13.7)ms,P<0.001]。结论二维斑点追踪超声纵向应变结果显示RVOT起搏时的左心室收缩同步性优于RVA起搏。

Evaluation of two-dimensional speckle tracking imaging on left ventricular systolic desynchronization in patients with right ventricular pacing at different sites

Objectives Using two-dimensional speckle tracking imaging （STI） technology to compare the difference of left ventricular systolic desynchronization in patients with right ventricular pacing at different sites. Methods Totally 60 consecutive patients with indication of permanent pacemaker implantation were randomly （1：1 random number table） assigned into two groups. Right ventricular lead was placed in right ventricular outflow tract septum （RVOTs） or right ventrieular apex （RVA） accordingly. STI was analyzed under the condition of 100% ventricular pacing and time to peak longitude strain （LS） was recorded after implantation. Results Time difference （TD） of time to peak strain on longitude strain in RVA group was significantly larger than that in RVOT group （161.6±43.9） ms vs. （74.3±13.7） ms, P〈 0.001 ]. Conclusions STI indicates that left ventricular synchronization of RVOT pacing is superior to RVA pacing.