难治性心衰伴左束支传导阻滞患者心室运动的研究

The study of cardiac ventricular movement in patients with heart failure and complete left bundle branch block

目的定量组织多普勒成像技术分析完全性左束支传导阻滞（CLBBB）患者心室运动的同步性。方法超声定量组织多普勒测量CLBBB伴左室射血分数正常的患者17例、CLBBB伴左室射血分数减低的患者20例和健康者为对照组20例，分别测量二尖瓣瓣环纵向运动的峰值速度、达峰时间，并使用脉冲多普勒测量主动脉瓣和肺动脉瓣开放及关闭时间等。结果CLBBB患者二尖瓣瓣环部等容收缩期时间延长，射血时间、充盈时间及收缩时间缩短；主动脉瓣开放时间较对照组明显延迟，射血期峰值速度、舒张早期及晚期峰值速度减低，且CLBBB伴射血分数减低组的各项指标改变尤为明显。结论定量组织多普勒成像能够准确、客观地评价心室运动的同步性，从而提高同步化治疗的应答率。

Objective To explore the synchronism of cardiac ventricttlar movement in patients with complete left bundle branch block（CLBBB） by quantitation tissue Doppler imaging. Methods To observe synchronization in Seventeen CLBBB patients with normal left ejection fraction （LEF） , 20 CLBBB patients with low LEF and 20 healthy subjects as control group were entolled in this study. Their peak value velocity and peak time of mitral annulus longitudinal movement were measured by quantitation tissue Doppler, and the open time and close time of aortic valve and puhnonary valve were measured by pulse Doppler. Results Isovolumic contraction time （IVCT） of mitral annulus in CLBBB patients was increased, the ejection time, filling time and systolic time was decreased. Furthermore, the peak velocity （ VS, VE） were lower in CLBBB groups than control group. Otherwise, the break time of AV was delayed more. Conclusion Quantitation tissue Doppler imaging can accurately and objectively evaluate the synchronization of vemtricular movement in patients with CLBBB, and improve the response rate of synchronization therapy.