超声心动图对左束支传导阻滞心室间非同步运动的评价

Evaluation of interventricular asynchrony in patients with left bundle branch block by echocardiogram

目的应用超声心动图技术评价左束支传导阻滞患者左右心室间运动的非同步性。方法对20例完全性左束支传导阻滞(LBBB)患者和20例正常人解剖M型在心室波群区观察室间隔与左室后壁运动;运用频谱多普勒成像技术测量左、右心室射血前期时间(LVPET、RVPET),计算两者之差PETd;采用定量组织速度成像技术(QTVI)测量右室侧壁基底段和左室各壁基底段达收缩期峰值速度时限(TS)和达舒张早期峰值速度的时限(TE)。结果LBBB患者室间隔运动异常,PET、PETd较正常对照明显延长(P<0.01),左室各壁基底段TS、TE均值较对照明显延长(P<0.01)。结论LBBB患者左室激动异常时电机械延迟,心室间运动存在明显的不同步。

Objective To evaluate interventricular asynchrony in patients with left bundle branch block by echocardiogram. Methods 20 patients with complete left bundle branch block （CLBBB） and 20 normal subjects were studied. The motion of interventricular sepal and posterior left ventricular wall were observed in ventricular echo pattern region using anatomic M - mode echocardiography. The pre - ejection period of left （LVPET） and right ventricular （RVPET） were measured by pulsed Doppler imaging. Then the difference of pre- ejection time （PETd） was calculated. The time to peak myocardial systolic contraction （TS） and early diastolic relaxation （TE） were measured on the basal segment of lateral wall of right ventricular and the basal segnent of different walls of left ventricular. Results Interventricular sepal motion was abnormal in patients with CLBBB. PET and PETd were longer than controls （ P 〈 0.01）. The mean of TS and TE on the basal segnent of different wails of left ventricular was longer than those in normal subjects. Conclusion Abnormal left ventricular activation sequence during LBBB caused electromechanical uncoupling, with interventricular asynchrony.