超声心动图在心脏再同步化治疗中的应用现状和进展

Advances in Echocardiography on Cardiac Resynchronization Therapy

心脏再同步化治疗（CRT）已经成为对于严重心力衰竭及内科难治性心力衰竭患者的一种可选择性治疗方法，几项较大的研究已经证明了CRT的有效性。CRT的治疗机制是改善房室同步性、室间同步性和室内同步性。超声心动图（ECG）尤其是各种新技术在准确评估心脏机械不同步运动的部位、范围及程度方面均具有重大作用。现详细介绍二维、M型及脉冲多普勒3种传统ECG技术和组织多普勒成像、二维斑点追踪成像和三维全容积等新技术如何评价心脏机械同步性。ECG在为CRT筛选合适患者，优化起搏程序，评价并随访疗效等方面具有重要临床意义。

Cardiac resynchronization therapy （CRT） has became an alternative treatment in patients with severe medically refractory heart failure in recent years. Several large studies have demonstrated the effectiveness of CRT, which can improve the atrioventricular, interventricular, and intraventricular dyssynchrony. Echocardiography plays an important role in precise assessment location, range and degree of cardiac mechanical dyssynchrony. This article introduce a series of traditional and novel technique of echocardiography, including M model, pulse wave Doppler, tissue Doppler imaging, speckle tracking imaging and three-dimensional full volume. Echocardiography shows important clinical meaning in searching suitable patients for CRT,optimizing AV and VV delay,evaluating and following up effect of CRT.