CAJ | 학술논문

目的应用常规超声及组织多普勒成像技术(TDI)探讨充血性心力衰竭(CHF)患者再同步化治疗(CRT)后左室舒张功能变化.方法 CHF患者31例,以CRT术后6个月左室收缩末容积降低≥10％为标准分为CRT有反应组(16例)和CRT无反应组(13例).所有患者均于CRT术前1～3 d、术后6个月接受超声检查.彩色M型超声测量二尖瓣口舒张期血流播散速度(Vp),计算E/Vp；TDI测量二尖瓣环四个位点的舒张早期运动速度(e),计算E/e；测量左室12节段心肌收缩期达峰时间(Ts-SD)、12节段Ts最大差值(Ts-Dif).结果与CRT术前比较,CRT有反应组12节段Ts-SD、Ts-Dif均显著缩短,Vp显著增高,二尖瓣环各位点及4个位点平均E/e、E/Vp显著降低,而CRT无反应组上述参数均无显著差异；CRT有反应组二尖瓣环4个位点平均E/e、E/Vp与左室12节段Ts-SD呈显著正相关.结论 CRT治疗有反应患者的左室舒张功能也得到改善,其机制可能与左室充盈压降低及左室松弛改善有关.
목적 응용상규초성급조직다보륵성상기술(TDI)탐토충혈성심력쇠갈(CHF)환자재동보화치료(CRT)후좌실서장공능변화.방법 CHF환자31례,이CRT술후6개월좌실수축말용적강저≥10％위표준분위CRT유반응조(16례)화CRT무반응조(13례).소유환자균우CRT술전1～3 d、술후6개월접수초성검사.채색M형초성측량이첨판구서장기혈류파산속도(Vp),계산E/Vp；TDI측량이첨판배사개위점적서장조기운동속도(e),계산E/e；측량좌실12절단심기수축기체봉시간(Ts-SD)、12절단Ts최대차치(Ts-Dif).결과 여CRT술전비교,CRT유반응조12절단Ts-SD、Ts-Dif균현저축단,Vp현저증고,이첨판배각위점급4개위점평균E/e、E/Vp현저강저,이CRT무반응조상술삼수균무현저차이；CRT유반응조이첨판배4개위점평균E/e、E/Vp여좌실12절단Ts-SD정현저정상관.결론 CRT치료유반응환자적좌실서장공능야득도개선,기궤제가능여좌실충영압강저급좌실송이개선유관.
Objective To evaluate the diastolic function in patients with congestive heart failure (CHF) after cardiac resynchronization therapy (CRT) by conventional echocardiography or Doppler tissue imaging (TDI).Methods 31 patients with CHF were divided into responders to CRT (group R) and nonresponders to CRT (group N) according the standard of a decline in left ventricular(LV) end-systolic volume ≥10％.All the patients received echocardiography examination 1-3 days before CRT and 6 month after CRT.Color M-mode echocardiography indices included Vp,E/Vp.TDI indices included the peak velocity in early diastole (e) at 4 sites of mitral annulus,E/e,time to peak velocity in systole (Ts),Ts-SD and maximum difference of Ts (Ts-Dif) among 12 segments.Results Compared with before CRT,Ts-SD and Ts-Dif significantly shortened in group R;Vp increased significantly,E/e at each 4 site and mean value at 4 sites of mitral annulus,E/Vp decreased significantly; but there were no significant difference in group N.There were significant positive correlation between mean value at 4 sites of E/e,E/Vp and Ts-SD in group R.Conclusions The diastolic function in responders to CRT improved after CRT,which was associated with the decreased LV filling pressure and improved LV relaxation.