Tei指数结合组织多普勒技术对右室心尖部起搏后近期全心功能重构评估

Evaluation of reconstruction of heart function in patients underwent short term right ventricular apical pacing by tissue Doppler imagine and Tei index

目的:利用Tei指数结合组织多普勒技术,评估右室心尖部起搏后对患者近期左、右室收缩及舒张功能的影响。方法:选取因症状性心动过缓安装VVI永久起搏器的患者30例,分别于术后1周、术后6个月行常规超声心动图及组织多普勒检查。通过测定左室射血分数(LVEF)和右室射血分数(RVEF),舒张早期跨二、三尖瓣血流峰值速度(E)和舒张晚期跨二、三尖瓣血流峰值速度(A),二、三尖瓣舒张早期峰值运动速度(E')与舒张晚期峰值运动速度(A'),分别计算左、右室的E/A、E'/A'、E/E'值及Tei指数。结果:与术后1周比较,术后6个月时患者LVEF和RVEF均明显降低[(58.45±8.49)%:(62.06±6.84)%,P<0.05;(48.33±6.37)%:(55.72±6.48)%,P<0.01];左、右室的E/E'明显升高[(11.10±2.56):(6.39±0.97);(8.43±2.79):(4.82±0.70),均P<0.01];左、右室的Tei指数也显著增高[(0.51±0.09):(0.37±0.06);(0.44±0.11):(0.32±0.08),均P<0.01]。结论:右室心尖部起搏导致患者近期左、右室的收缩与舒张功能轻度受损,组织多普勒对全心功能的评估有很好的临床指导作用。

Objective：To evaluate the reconstruction of heart function in patients underwent short term right ventricular apical pacing by tissue Doppler imagine and Tei index.Method：Thirty patients who had received permanent VVI pacemakers due to bradycardia were studied.Each patient underwent standard echocardiographic examination and tissue Doppler imagine respectively on a week and six months after implantation.Result：Compared with a week after implantation,LVEF [（58.45±8.49）% vs（62.06±6.84）%,P0.05] and RVEF [（48.33±6.37）% vs（55.72±6.48）%,P0.01] were significantly decreased in 6 months after implantation.The E/E′ of left ventricular [（11.10±2.56） vs（6.39±0.97）,P0.01] and right ventricular [（8.43±2.79） vs（4.82±0.70）,P0.01] were significantly increased.The Tei index of left ventricular [（0.51±0.09） vs（0.37±0.06）,P0.01] and right ventricular [（0.44±0.11） vs（0.32±0.08）,P0.01] remarkably increased.Conclusion：Short term right ventricular apical pacing leads to mild dysfunction of systolic and diastolic of left and right ventricular.Tissue Doppler imagine has better clinical guidance than traditional evaluation of heart function.