利用心肌综合指数评价左束支传导阻滞患者局部舒缩功能

Assessment of Regional Systolic and Diastolic Function in Patients With Left Bundle Branch Block by Myocardial Performance Index

目的 :超声评价左束支传导阻滞 (LBBB)患者左心室局部心肌的收缩和舒张功能。 方法 :超声测量 15例LBBB患者 (LBBB组 )和 15例正常人 (对照组 )二尖瓣瓣环 ,获得等容收缩期进间(LCT)、射血期时间 (ET)、等容舒张期时间、舒张期的持续时间以及LCT/ET ,评价左心室整体和局部心肌综合指数。此外 ,测量等容收缩期波峰的加速时间、射血期波峰的加速时间、E波的减速时间等。 结果 :LBBB组较对照组左心室各壁等容收缩期时间明显延长 ,而舒张充盈时间缩短 ,左心室后间隔、下壁、后壁的等容舒张期时间延长 ,LCT/ET增加 ,局部心肌综合指数明显升高 ,左心室后间隔、下壁的等容收缩期波峰的加速时间明显延长 ,E波的减速时间在后间隔、下壁、后壁明显缩短 ,均有显著性差异 (P〈0 . 0 5～ 0 . 0 1)。 结论 :LBBB时左心室整体和局部心肌综合指数明显异常 ,提示左心室整体和局部舒缩功能受损。利用组织多普勒测量心肌综合指数可以快速、无创。

Objective:To observe regional systolic and diastolic function of left ventr icular myocardium in patients with left bundle branch block. Methods:Left ventricular myocardium of 15 patients with left bundle branch b lock (LBBB group) and 15 normal persons (Control group) were assessed by Doppler tissue imaging.The echocardiographic images of all cases were collected and ana lyzed off-line.The profiles of left ventricular myocardial velocity were investi gated in mitral annulets of different walls,the time of isovolumic contraction ( LC T),ejection (ET),isovolumic relaxation (IRT),diastolic filling (DFT) and IVC/ET were obtained.Total and regional left ventricular myocardial performance indexe s were calculated.Furthermore,the acceleration time of isovolumic contraction wa ve (IVA),the acceleration time of the S wave (Sac),the deceleration time of the E wave (Edc) were measured. Results:ICT in different sites of left ventricule of LBBB group was all increased.In the left ventricular septal,inferior,posterior walls of LBBB gr oup,IRT was longer,DFT was shorter and ICT/ET was higher,regional myocardial per formance index was higher.IVA was significantly lengthened,and Edc shortened in the left ventricular septal,inferior walls of LBBB group. Conclusions:Total and regional left ventricular myocardial peerf ormance indexes were apparently abnormal in left bundle branch block patients,su ggesting that left bundle branch block made both total and regional systolic and diastolic function impaired.Tissue velocity imaging can quickly,non-invasively, sensitively assess regional myocardial function.