超声斑点跟踪显像评价房室顺序起搏患者左心室收缩功能

Evaluation of left ventricular systolic function in patients with cardiac pacing by ultrasonic speckle tracking imaging

目的探讨超声斑点跟踪显像技术评价房室顺序起搏患者左心室收缩功能的价值。方法用超声斑点跟踪显像技术分别检测房室顺序起搏心房起搏心房感知抑制型（AAI）模式患者10例（A组）、房室顺序起搏双心腔起搏双心腔感知触发和抑制型（DDD）模式患者10例（B组）及正常对照10例（C组）的左心室16个节段的径向位移、速度及应变指标，并与常规超声心动图测量所得左心室射血分数（EF值）进行相关分析和比较。结果三组间左心室EF值、收缩期16节段径向位移峰值均数、径向速度峰值均数与径向应变峰值均数差异均无统计学意义（P〉0．05）。B组与C组相比，径向位移峰值在左心室下壁基底段、间隔基底段及心尖段降低，径向应变峰值在下壁及间隔心尖段降低，差异有统计学意义（P〈0．05）。A组与C组相比，左心室各个节段的径向位移、径向速度与径向应变峰值差异均无统计学意义（P〉0．05）。结论房室顺序起搏DDD模式时，左心室下壁及间隔的基底段和心尖段收缩功能降低，AAI模式时左心室节段性收缩功能无明显改变。

Objective To evaluate left ventricular systolic tunction in patients with dual-chamber pacing by ultrasonic speckle tracking imaging. Methods The left ventricular radial displacement,velocity and strain of 10 patients with single atrial （AAI） pacing （group A）, 10 patients with dual-chamber （DDD） pacing （group B） and 10 volunteers （group C） were studied at 16 segments using ultrasonic speckle tracking imaging, and the results were compared with the left ventricular ejection fraction （EF）. Results There were no significant intergroup differences in mean of left ventricular peak radial displacement, peak radial velocity, peak radial strain and EF in the three groups（ P 〉0.05）. Compared with C group,the peak radial displacement of left ventricular inferior wall in basal,septum in basal and apical was decreased,and the peak radial strain of left ventricular inferior wall in apical and septum in apical was decreased in group B（ P 〈0.05）. There was no significant difference in left ventricular peak radial displacement , peak radial velocity , and peak radial strain between group A and group C （ P 〉0. 05）. Conclusions In patients with cardiac pacing,the regional left ventricular systolic function of inferior wall and septum in basal and apical was decreased during DDD pacing, and there were no obvious changes of regional left ventricular systolic function during AAI pacing.