组织速度结合应变率对完全性左束支传导阻滞的左室功能的分析

The function of left ventricular in complete left bundle branch block with tissue velocity imaging and strain rate imaging

目的探讨组织速度(TVI)结合应变率对分析完全性左束支传导阻滞(CLBBB)患者的左室整体和局部收缩和舒张功能。方法对21例完全性左束支传导阻滞患者(CLBBB组)与20例正常者(正常对照组)采用组织速度结合应变率显像(SRI)技术分别测定其左室基底段及中段沿左室长轴运动的收缩期峰值速度(Vs)、峰值应变率(SRs)、舒张早期峰值速度(Ve)、舒张早期应变率(SRe)、舒张晚期峰值速度(Va)、舒张晚期应变率(SRa),并测定其左室射血时间(ET)和左室充盈时间(DFT)。用Simpson法测量左室射血分数(LVEF)。结果 (1)CLBBB组室间隔及左室下壁基底段及中段的Vs、Ve、SRs、SRe值均低于正常对照组(P<0.05);(2)CLBBB组ET、DFT均较正常对照组缩短(P<0.05)。(3)CLBBB组左室EF值与室间隔的Vs、Ve、SRs、SRe及DFT呈正相关(P<0.05)。结论组织速度结合应变率显像技术可作为CLBBB患者左室整体运动和局部舒缩活动的评价手段之一,为临床治疗提供了一定的参考价值。

Objective To explore the function of left ventricular with tissue velocity imaging and strain rate imaging in complete left bundle branch block（CLBBB） patients.Methods The left ventricular regional systolic and diastolic velocity and strain rate in 21 CLBBB patients and 20 health subjects were analyzed by TVI and SRI.Peak systolic velocity（Vs）,early diastolic velocity（Ve）,late diastolic（Va） velocity,systolic peak strain rate（SRs）,early diastolic strain rate（SRe）,late diastolic strain rate（SRa） were measured respectively.Ejection time（ET） and diastolic filling time（DFT） of left ventricular were also measured.Left ventricular ejection fraction（LVEF） was determined by Simpson method.Results（1） The longitudinal SRs,SRe,Vs and Ve of the basal and middle of interventricular septum were lower in CLBBB group than those in normal control group（P0.05）.The SRs,Vs,Ve and SRe of left ventricular inferior wall were lower in CLBBB group than those in normal control group（P0.05）;（2） ET and DFT were shorter in CLBBB group（P0.05）.（3） There was a positive correlation between LVEF and Vs,Ve,SRs,SRe of IVS in CLBBB group（P0.05）.There was a positive correlation between LVEF and LVDFT in CLBBB group（P0.05）.Conclusion TVI and SRI would be a new and accurate method to evaluate both total and regional systolic and diastolic function of left ventricular in CLBBB,which may take some clinical information.