三平面组织追踪技术评价不同QRS间期心肌梗死患者左室不同步运动

Evaluation of left ventricular dyssynchrony in myocardial infarction patients with normal and wide QRS duration by triplane tissue tracking imaging

目的应用三平面组织追踪评价不同QRS间期心肌梗死患者左室不同步运动。方法对30例正常人和60例心肌梗死患者(QRS间期≤120ms者30例,QRS间期>120ms者30例)采集心尖四腔观三平面组织速度图像,取左室6个壁的基底段和中间段,总共12个节段。应用组织追踪技术测量各节段收缩达位移峰的时间(Td),计算最大差值(Td-maxD)和标准差(Td-sD)。结果两组心肌梗死患者与正常组比较,同步性指数Td-maxD、Td-sD均显著延长(P<0.05)。QRS间期延长与QRS间期正常的心肌梗死患者之间Td-maxD、Td-sD比较差异有显著性(P<0.05)。结论左室心肌的不同步运动在QRS间期正常及增宽的心肌梗死患者广泛存在。QRS间期>120ms不能作为选择心脏再同步化治疗的可靠依据。

Objective To evaluate the left intraventricular systolic dyssynchrony in myocardial infarction （MI） patients with normal and wide QRS duration by triplane tissue tracking imaging （Triplane-TTI）. Methods Thirty healthy persons （control group） and sixty MI patients（ 30 with QRS duration ≤ 120 ms, 30 with QRS duration 〉 120 ms） were derected by triplane tissue tracking imaging, then the triplane tissue velocity images at apical four-chamber view were obtained. The 6 walls of the left ventricle were divided into basal and middle segments（ 12 Segments）. Time of peak displacement （Td） was measured, then the maximal difference in Td （Td-maxD） and the standard deviation of Td （Td-sD） were calculated. Results The dyssynchrony indexes （Td-maxD, Td-sD） in the MI patients were much longer than those in control subjects （P 〈 0. 05）. There was significant difference of Td-maxD and Td-sD between wide QRS subgroup and normal one （P 〈 0. 05 ）. Conclusion Left ventricular dyssynehrony is common in MI patients with normal and wide QRS duration. QRS During 〉 120 ms can not be selected as cardiac resynchronization therapy reliable evidence.