组织同步显像评价左心室内收缩失同步

Evaluation on left ventricular dyssynchrony using tissue synchronization imaging

目的应用组织同步显像(TSI)观察左心室内心肌收缩运动失同步,探讨快速准确判定心室内运动不协调的方法。方法收集完全性左束支传导阻滞患者(LBBB组)28例及正常志愿者(对照组)28名,以TDI测量左心室12节段的收缩达峰时间(Ts),计算收缩达峰时间的标准差(Ts-SD)。分别设定不同的TSI处理时间,根据二维图像显示的色彩计算TSI积分。结果与对照组相比,LBBB组Ts延长,Ts-SD增大,TSI积分明显增加。LBBB组共有36个节段(36/336,10.71%)存在严重收缩后收缩(PSS)现象。TSI处理时间设定在收缩期时与等容舒张期时的严重PSS节段的平均TSI积分与仅设定在收缩期时差异有统计学意义(3.60±0.37vs 2.30±0.48,P<0.001)。结论在正确设定处理时间的前提下,利用TSI可以直观评价左心室心肌收缩运动不同步。

Objective To evaluate the correlation of the visual assessment of left ventricular （LV） dyssynchrony using tissue synchronization imaging （TSI）, and to establish the easy and accurate TSI approaches. Methods Totally 28 patients with left bundle branch block （LBBB group） and 28 healthy subjects （control group） were enrolled. The time to peak sys- tolic velocity （Ts） in 12 left ventricular segments was measured manually using TDI, and the standard deviation of Ts （Ts- SD） was calculated. TSI index during different TSI intervals were calculated based on TSI color analysis of 12 segments. Results Compared with control group, the Ts, Ts-SD and the TSI index significantly prolonged in LBBB group. In LBBB group, severe post-systolic shortening （PSS） were found in 36 segments （36/336, 10. 71 ~/＇~0）. There was significant statis- tical difference of TSI index （3.60-t-0.37 vs 2.30~0.48, P^0. 001） in those segments between isovolumic relaxation with ejection phase and ejection phase. Conclusion Left ventricular dyssynchrony may be visually assessed by TSI with appro- priate TSI intervals.