组织同步显像在心脏再同步优化治疗中的应用

Tissue synchronization imaging application in optimized cardiac resynchronization therapy

目的:探讨组织同步显像在心脏再同步优化治疗的应用价值。方法:32例行双心室优化起搏治疗的心衰患者,术前,术后1个月、3个月、6个月分别进行组织同步显像及常规超声检查,在心尖四腔心切面、两腔心切面、三腔心切面分析组织同步指数及达峰时间差。常规超声指标包括:左室舒张末内径、收缩末内径、二尖瓣反流面积、左室射血分数、二尖瓣舒张充盈时间、主动脉时间速度积分。结果:与术前相比,术后1个月、3个月、6个月组织同步指数及达峰时间差降低(P<0.05)。左室舒张末内径、收缩末内径、二尖瓣反流面积逐渐减小(P<0.05),左室射血分数、二尖瓣舒张充盈时间、主动脉时间速度积分逐渐增加(P<0.05)。结论:组织同步显像可以快捷地评价机械不同步,为心脏再同步优化治疗提供有力的手段。

Objective： To apply tissue synchronization imaging （TSI） to evaluate optimized cardiac resynehronization therapy （CRT）, Methods： Thirty-two patients with optimized CRT were included. TSI and conventional echocardiography were performed before implantation, 1m, 3m, 6m after implantation. In apical 4, 2, 3 chamber plane, TSI index and the peak time difference were assessed. Conventional echocardiographic parameters included： LVEDD （left ventricular end-diastolic diameter）, LVESD （left ventricular end-systolic diameter）, LVEF （left ventricular ejection fraction）, MR area, mitral diastolic filling time （DFT）, aortic VTI. Results： Compared with pre-implantation, TSI index and peak time difference were significantly reduced in pro lm, pro 3m, pro 6m（P〈0.05）, LVEDD, LVESD, MR decreased progressively（P〈0.05）, while LVEF, DFT, VTI increased progressively（P〈0.05）. Conclusions： TSI allows quick evaluation of mechanical dyssynchrony and provides a reliable way to evaluate optimized CRT.