实时三维超声心动图评价永久起搏患者左心室收缩同步性和心功能

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1、万方数据生堡!垒查萱痘盘查垫!Q生≥旦筮!!鲞筮!翅堡蝤!!垦竺查生：丛!!也垫!Q：№!：塑奠!：!实时三维超声心动图评价永久起搏患者左心室收缩同步性和心功能蔡剑锋王如兴李肖蓉戴敏张常莹刘晓宇钱大钧·215-．心力衰竭研究．【摘要】目的探讨应用实时三维超声心动图(RT-3DE)评价永久起搏患者左心室收缩同步性和心功能。方法15例病态窦房结综合征置入双腔起搏器患者，分别将起搏模式程控为心房抑制型按需起搏(AAI)、房室按需型起搏(DDD)、心室抑制型按需起搏(wI)，每种起搏模式稳定5min后，在RT-3DE下取左心室全容积图像。应用Qlab4．2脱机分析软

2、件，获得左心室整体与17节段容积一时间曲线和比较左心室16、12、6节段心电图QRS波起点至左心室最小容积点时间的标准差和最大时间差(即Tmsvl6-S、Tmsvl2-s、Tmsv6-8、Tmsvl6-dif、Tmsvl2-dif、Tmsv6一dif)、左心室舒张末期容积、左心窒收缩末期容积、左心室射血分数、左心室舒张早期峰值充盈率、左心室17节段的舒张末期容积、收缩末期容积和节段射血分数。结果心室同步性指标容积一时间曲线和Tmsvl6一s、Tmsvl2-s、Tmsv6一S、Tmsvl6．dif、Tmsvl2一dif、Tmsv6一dif在AAI模式明显优于D

3、DD、WI模式(P<0．05)，心功能指标左心窒射血分数、左心室舒张早期峰值充盈率在AAI模式下显著高于DDD和VVI模式(P<0．05)；DDD和VVl模式的上述指标差异无统计学意义(P>0．05)；DDD与VVl模式时左心室前间隔、下壁和后壁基底段、心尖段节段射血分数较AAI模式明显降低(P<0．05)。结论采用RT-3DE可客观准确地评价永久起搏患者左心室收缩同步性和心功能。【关键词】心脏起搏，人工；超声心动描记术；心室功能，左Ev蚰uafiononleftventricularsystolicsyachronidtyandcardiacfunctio

4、ninpatientswithpermanentcardiacpacingbyreal-timethree—dimensionalechocardiographyCAIJmn-feng，WANGRu-xing，L，Xiao—rong。DA

5、Min，ZHANGChang-ying．uUXiao-yu，QIANDa-jurrCardiacCenter，W蛹People’sHospitalAffiliatedtO^k硝ngMedicalUniversity。形眦i2J讹3，ChinaCo硼pondingauthor：彤tMRu-xing．Email：ruxingw

6、@yahoo．com．cn【Abst耐】ObjectiveTodeterminethefeasibilityontheleftventricularsystolicsynchronicityandcardiacfunctionevaluationinpatientswitIlpermanentcardiacpacingbyreal．timethree—dimensionalechocardiography．MethodsFifteenpatientswithsicksinussyndromepostdual—chamberpacemakerimplantat

7、ionwereenrolledinthisstudy．PacemakerswereprogrammedtoAAI．DDD．andVVIrespectively．Afterpacingfor5minutesineachmode．participantswereexaminedwi山real—timethree-dimensionaleehoeardiography．Imagesindifferentpacingmodeswereobtainedandanalyzedbytheoff-lineQIab4．21$oftware．Parametersincludin

8、gglobaland17．segmentalvolume-timecurve8(VTCs)，dispersionoftimetoIIlinirealregionalvoltimefor16，12，and6leftventricularsegments(Tmsvl6一s，Tmsvl2-s，Tmsv6一B)，andmaximaldifferenceoftimetominimalregionalvolumef打16。12and6leftventrieularsegments(Tmsvl6．dif。TinSVl2-dif，Tmsv6．dif)，enddiastoli

9、evolume(EDV)，endsystolicvo