超声TVI技术评价冠心病右束支传导阻滞患者心室舒缩同步性的研究

Evaluation of systolic and diastolic ventricular synchronization in coronary heart disease patients with complete right bundle branch block by Doppler tissue velocity imaging

目的:应用多普勒组织速度成像(TVI)技术评价冠心病右束支传导阻滞患者心室舒缩的同步性。方法:选择冠心病合并完全性右束支阻滞(CRBBB)患者35例及正常人31例(对照组)进行心肌多普勒组织显像研究,⑴测量收缩期和舒张早期左、右室基底段和中间段共14节段的达峰时间(Ts和Te),并计算右室2节段收缩达峰时间平均值(Ts-2-RV)及左室12节段收缩和舒张达峰时间平均值(Ts-12-LV和Te-12-LV)、左室12节段达峰时间的标准差(Ts-12-SD和Te-12-SD)和最大差值(Ts-diff和Te-diff)。⑵测量左室收缩和舒张末内径(LVEDs和LVEDd)及容积(LVEVs和LVEVd)。结果:(1)CRBBB组左右室14节段收缩期达峰时间较对照组延长(除后间隔基底段和中间段P<0.05,其余各节段均为P<0.01),Ts-12-LV、Ts-12-SD、Ts-diff均长于对照组(P<0.01),CRBBB组中Ts-2-RV较Ts-12-LV延长(P<0.05)。(2)CRBBB组左右室14节段舒张早期达峰时间与对照组相比无差别(P>0.05),但左室Te-12-SD、Te-diff均长于对照组(P<0.01)。结论:冠心病CRBBB患者除有心室间的收缩不同步,亦有心室内的收缩及舒张不同步。

Objective： To evaluate the ventricular synchronization of systolic and diastolic in coronary heart disease patients with the complete right bundle branch block （CRBBB） by Doppler tissue velocity imaging （TVI） technology. Methods： 35 coronary heart disease patients with CRBBB were selected and compared with 31 controls with TVI. The parameters of myocardial imaging were evaluated. Time to peak velocity were measure at systolic and early diastolic phase （Ts and Te） in the base and interlude altogether 14 segments of left and right ventricular in all subjects. The average time of Ts in right ventrieular 2 segments（Ts-2-RV）, the average time of Ts and Te in left ventricular 12 segments （Ts-12-LV and Te-12- LV）, 12 segments standard deviation （Ts-12-SD and Te-12-SD）and 12 segmental maximal Ts and Te 6 difference （Ts-diff and Te-diff）were calculated .The left ventricular end systolic and diastolic diameter （LVEDs and LVEDd） and the volume （LVEVs and LVEVd）were measured. Results： （1） The 14 segments Ts of left and right ventricular in CRBBB were longer than those in control group （the base and interlude of interventricular septum were P〈0.05, and Other various segments were P〈0.01 ）. Compares with the control group, the Ts-12-LV,Ts-12-SD and Ts-diff showed significant prolongation （P〈0.01）.The Ts-2-RV was longer than the Ts-12-LV in CRBBB group（P〈0.05）. （2） The time to peak velocity at early diastolic phase in 14 segments were failed to demonstrate any statistically significant differences（P〉0.05） between CRBBB group and control group, but the Te-12-SD and Te-diff in CRBBB were longer than those in control group （P〈0.01）. Conclusion： In coronary heart disease patients with CRBBB ventricular contraction is not synchronized, the interventricular systolic and diastolic are also asynchrony.