CAJ | 학술논문

目的探讨实时三维超声心动罔技术评价房室顺序双心腔起搏、感知触发和抑制型(DDD)模式起搏器植入患者左室心肌收缩同步性和整体收缩功能的价值.方法应用实时三维超声心动图对20例DDD模式起搏器植入患者和20例正常人进行左室心肌收缩同步性和整体收缩功能检测,得到左心室舒张末期容积(LEDV)、收缩末期容积(LESV)、每搏量(SV)、射血分数(LVEF)、17节段心电图QRS波起始点至左心室最小容积点时间的平均值(Tmean)及其标准差(T-SD)、17节段心电图QRS波起始点至左心室最小容积点时间的最大差值(Tmax).结果与对照组相比,病例组LESV增大,LVEF、SV减小,T-SD、Tmax延长,差异均有统计学意义(P<0.01);两组LEDV、Tmean差异均无统计学意义(P>0.05);病例组中LVEF与T-SD、Tmax呈负相关(r分别为-0.674和-0.634,P<0.05).结论 DDD模式起搏器植入患者存在一定程度的左室心肌收缩失同步和整体收缩功能减退,应用实时三维超声心动图可对其进行定量评价.
목적 탐토실시삼유초성심동망기술평개방실순서쌍심강기박、감지촉발화억제형(DDD)모식기박기식입환자좌실심기수축동보성화정체수축공능적개치.방법 응용실시삼유초성심동도대20례DDD모식기박기식입환자화20례정상인진행좌실심기수축동보성화정체수축공능검측,득도좌심실서장말기용적(LEDV)、수축말기용적(LESV)、매박량(SV)、사혈분수(LVEF)、17절단심전도QRS파기시점지좌심실최소용적점시간적평균치(Tmean)급기표준차(T-SD)、17절단심전도QRS파기시점지좌심실최소용적점시간적최대차치(Tmax).결과 여대조조상비,병례조LESV증대,LVEF、SV감소,T-SD、Tmax연장,차이균유통계학의의(P<0.01);량조LEDV、Tmean차이균무통계학의의(P>0.05);병례조중LVEF여T-SD、Tmax정부상관(r분별위-0.674화-0.634,P<0.05).결론 DDD모식기박기식입환자존재일정정도적좌실심기수축실동보화정체수축공능감퇴,응용실시삼유초성심동도가대기진행정량평개.
Objective To assess the left ventricular synchronization and global systolic function in patients with implanted dual-chamber (DDD) mode cardiac pacemakers by real-time three-dimensional echocardiography(RT-3DE). Methods Left ventricular systolic synchronization and global function were evaluated in 20 patients with implanted DDD mode cardiac pacemakers and 20 normal people by RT-3DE. The left ventricular end-diastolic volume (LEDV), end-systolic volume ( LESV), stroke volume (SV), left ventricular ejection fraction (LVEF), the mean value of time from the start of electrocardiographic QRS wave to the point of minimal systolic volume (Tmean) of the 17 segments and those standard deviation(T-SD),the maximal difference of time among all 17 segments(Tmax) were obtained by RT-3DE. Results Compared with control group, LESV was significantly increased,SV, LVEF were significantly decreased and T-SD,Tmax were significantly prolonged (P <0.01 ). There were no differences in LEDV and Tmean between the two groups (P>0.05). In patients group,LVEF correlated closely with T-SD (r =-0.674, P<0.05) and Tmax (r = - 0. 634, P < 0. 05). Conclusions There were left ventrieular systolic asychronization and global systolic dysfunction in patients with implanted dual-chamber (DDD) mode cardiac pacemakers,which could be assessed by RT-3DE.