组织多普勒评价扩张型心肌病心房电机械传导间期及左心房内、左右心房间不同步性

Assessment of Atrial Electromechanical conduction time,and Intratrial and Interatrial asynchrony in Patients with Dilate Cardiomyopathy by Tiusse doppler imaging

目的应用组织多普勒评价扩张型心肌病(DCM)心房电机械传导间期及左心房内、左右心房间不同步性。方法选择DCM组共31例和正常人30例。测量心电图P波起始点至心尖四腔观二尖瓣前瓣、后瓣及三尖瓣前瓣组织多普勒曲线上A波起始点的时限即心房电机械传导间期(P-LA、P-IAS、P-RA),计算左房内不同步性[P-LA与P-IAS差值(T1)]、左右心房同不步性[P-LA与P-RA差值(T2)]。结果 DCM组P-LA、P-IAS、P-RA较对照组明显延长(P<0.05),DCM组T1、T2较对照组明显增大(P<0.05)。DCM组P-LA、P-IAS及T1、T2与左心房容积参数呈正相关(r=0.520～0.949,P<0.05),而P-LA及T1、T2与LAEF呈明显负相关(r=-0.549～-0.848,P<0.05)。结论 DCM存在左心房电机械传导间期延长、左心房内及左右心房间不同步运动,且与心房增大及功能降低关系密切。

Objective To evaluate atrial electromechanical conduction time, intratrial and interatrial asynchrony in patients with dilated cardiomyopathy （DCM） by tissue doppler imaging （TDI）. Methods Thirty -one patients with DCM and thirty healthy subjects received TDI. The intervals from the initiation of the P wave on the electrocardiogram （ECG） to the onsets of TDI -derived late diastolic velocity at the late the anterior mitral annulus （P- IAS）, lateral mitral annulus （P- LA） and tricuspid annulus （P- RA） were measured. LA asynehrony was defined as the difference between P - LA and P - IAS （ T1 ） , while interatrial asynchrony as the difference between P - LA and P - RA （ T2 ）. Results Significantly prolonged T1, T2, and atrial eleetromechanical conduction times of P - LA, P - IAS and P - RA were observed in DCM group （P 〈 0. 05 ）. Moreover, there were significantly positive correlations between P - LA, P - IAS, T1 or T2 and left atrial volume （ r = O. 520 ～ 0. 949, P 〈 0. 05 ） ; and there were significantly negative correlations between P - LA, T1, T2 or LAEF （ r = - 0. 549 - - 0. 848, P 〈 0.05 ）. Conclusion Patients with dilated cardiomyopathy present prolonged left atrial electromechanical conduction time, left intratrial and interatrial asynchrony. Furthermore, these correlate with atrial dilation and atrial function impairment.