超声组织同步检测评价老年心肌梗死伴传导阻滞致左心室收缩不同步的研究

TSI in assessment of left ventricular desynchronous contractions due to conduction block in elderly patients with myocardial infarction

目的探讨超声组织同步显像技术评价老年心肌梗死患者不同传导阻滞所造成的心室各壁收缩不同步性的临床价值。方法选择老年心肌梗死患者52例,根据心电图传导阻滞情况分为右束支阻滞组14例,左束支阻滞组21例,房室传导阻滞组17例,采用超声组织同步显像技术对所有患者的3个左心室心尖长轴观的后间隔、侧壁、前壁、下壁、前间隔、后壁的基底段和中间段进行心肌收缩达峰时间(TTP)的检测,并进行比较与分析。结果右束支阻滞组TTP延长部位位于前间隔中段、基底段以及后间隔中段。左束支阻滞组TTP延长部位主要位于后间隔中段及基底段、左心室下壁中段及基底段、左心室后壁中段及基底段,前间隔中段及基底段、左心室前壁基底段TTP也轻度延迟。房室传导阻滞组TTP延长部位位于左心室侧壁中段及基底段、后间隔中段、左心室后壁中段及基底段。结论老年心肌梗死后伴不同传导阻滞所产生的左心室收缩不协调部位不同,超声组织同步显像技术能直观并且准确检测出左心室收缩不同步的部位,并进行量化。

Objective To study the tissue synchronization imaging （TSI） in assessment of left ven- tricular desynchronous contractions due to conduction block in elderly patients with MI. Methods Fifty-two elderly MI patients were divided into right bundle branch block group （n= 14） ,left bun- dle branch block group （n= 21）, and atrioventricular block group （n= 17） according to their ECG. Their myocardial contraction peak time of basal and middle segments of the posterior septal,later- al,anterior,inferior,anterior septal and posterior walls was detected by TSI technology and ana- lyzed. Results The time to peak systolic velocity was longer in the middle segments of anterior septal,basal and posterior walls of the right and left bundle branch block groups,in the middle segments of posterior, basal, inferior, anterior walls of the left bundle branch block group, and in the middle segments of lateral, basal,posterior walls of the atrioventricular block group. Conclu- sion The sites of left ventricular desynchronous contractions due to conduction block were dif- ferent in elderly MI patients. TSI could directly show and quantify them.