CAJ | 학술논문

目的：应用实时三维超声心动图评价右室不同部位起搏对左室收缩功能及收缩同步性的影响。方法：将行双腔起搏器植入术的20例房室传导阻滞患者按起搏部位的不同分为右室心尖部起搏组（RVA 组）和右室流出道起搏组（RVOT 组）。两组患者均于术前及术后3个月应用二维及三维超声心动图检查左室容积、射血分数、LV区域壁运动，并比较两组患者的左室收缩功能及收缩同步性指标。结果：术后两组16节段、12节段、6节段达到最小容积时间的最大差值和标准差（T m sv-dif ， Tmsv-dif％，Tmsv-sd ，Tmsv-sd％），差异无统计学意义（P＞0．05），但RVOT组左室收缩同步性高于RVA组（P＜0．05）；两组常规二维超声参数及左室整体收缩功能差异无统计学意义（P＞0．05）。结论：短期内，右室不同部位起搏不影响左室整体收缩功能和左室收缩同步性。
목적：응용실시삼유초성심동도평개우실불동부위기박대좌실수축공능급수축동보성적영향。방법：장행쌍강기박기식입술적20례방실전도조체환자안기박부위적불동분위우실심첨부기박조（RVA 조）화우실류출도기박조（RVOT 조）。량조환자균우술전급술후3개월응용이유급삼유초성심동도검사좌실용적、사혈분수、LV구역벽운동，병비교량조환자적좌실수축공능급수축동보성지표。결과：술후량조16절단、12절단、6절단체도최소용적시간적최대차치화표준차（T m sv-dif ， Tmsv-dif％，Tmsv-sd ，Tmsv-sd％），차이무통계학의의（P＞0．05），단RVOT조좌실수축동보성고우RVA조（P＜0．05）；량조상규이유초성삼수급좌실정체수축공능차이무통계학의의（P＞0．05）。결론：단기내，우실불동부위기박불영향좌실정체수축공능화좌실수축동보성。
Objective:To explore the impacts of right ventricular alternative site pacing on left ventricle contractibility and sys-tolic synchronicity by real-time three dimensional echocardiography .Methods :Tweenty patients with atrio-ventricular (AV ) blocks undergoing dual-chamber pacemaker implantation were divided into the right ventricular apex pacing group (Group RVA) and the right ventricular outflow tract pacing group (Group RVOT ) according to the different pacing sites . Left ventricular volume ,ejection fraction and LV regional wall motion were assessed by echocardiography before and 3 months after operation .The left ventricle contractibility and systolic synchronicity were compared between the two groups .Results:Stand-ard deviation and difference of time to minimum systolic volume (Tmsv-dif ,Tmsv-dif% ,Tmsv-sd ,Tmsv-sd% ) of 16 seg-ments ,12 segments and 6 segments ,LV volume ,excursion and regular 2D parameters do not differ .Conclusions :RVA and RVOT pacing are the same in terms of LV synchrony in short time follow-up .