GSPECT MPI相位分析技术评价WPW综合征患者左室收缩同步性

Left ventricular systolic synchrony assessed by phase analysis of gated SPECT myocardial perfusion imaging in patients with Wolff-Parkinson-White syndrome

目的:运用SPECT门控核素心肌灌注显像(ECG-gated myocardial perfusion SPECT imaging,GSPECT MPI)相位分析技术探讨Wolff-Parkinson-White syndrome(WPW)综合征患者左室机械收缩同步性。方法:入选WPW患者35例和正常对照13例,均行GSPECT MPI检查,其中WPW患者GSPECT MPI检查在导管射频消融(radiofrequency current catheter ablation,RFCA)术前进行,计算出LVEF,MPI数据通过相位分析生成定量指标相位直方图带宽(phase histogram bandwidth,PHB)来评估WPW患者左室机械收缩同步性。根据RFCA术中阻断旁道部位对WPW患者进行分类(间隔旁道组、左侧游离壁旁道组、右侧游离壁旁道组)。结果:间隔旁道WPW患者组、左侧游离壁旁道WPW患者组、右侧游离壁旁道WPW患者组、正常对照组LVEF组间比较差异无统计学意义(P>0.05);间隔旁道WPW患者组与正常对照组PHB比较差异有统计学意义(P<0.05),间隔旁道WPW患者存在左室机械收缩不同步,左或右侧游离壁旁道WPW患者组与正常对照组PHB比较差异无统计学意义(P>0.05),左或右侧游离壁旁道WPW患者左室机械收缩不同步不明显。结论:GSPECT MPI相位分析表明间隔部旁道WPW患者存在左室机械收缩不同步。

Objective： To observe left ventricular（LV） mechanic systolic synchrony in patients with Wolff-Parkinson-White （WPW） syndrome by phase analysis of gated SPECT myocardial perfusion imaging（GSPECT MPI）. Methods： 35 WPW patients and 13 normal subjects with normal cardiac function were enrolled. They all had phase analysis of GSPECT MPI, 35 WPW patients had phase analysis of GSPECT MPI pre RFCA. Electrophysiological study（EPS） was used to locate accessory pathways（APs） and categorize the patients according to the AP locations（septal group, left free wall group and right free wall group）. Phase analysis was used to analyze the GSPECT MPI data to assess LV mechanic systolic synchrony. Results： There are no statistically differences comparing LVEF between septal group,left free wall group,right free wall group and control group（P〉0.05）. Significant increment of PHB was observed in WPW patients with AP in septal, and there are s^atistically differences between septal group and control group（P〈0.05）. There are no statistically differences comparing PHB between control group and left free wall group or right free wall group（P〉0.05）. WPW patients with accessory pathways in septal have LV mechanic systolic dyssynchrony. Conclusion： Phase analysis demonstrated that LV mechanic systolic dyssynchrony is present in patients with WPW, especially in those with septal APs.