CAJ | 학술논문

目的：应用超声心动图技术比较孤立性左束支传导阻滞患者与缺血性心肌病（ICM）伴完全性左束支传导阻滞（CLBBB）患者左心室内、左右心室间收缩运动同步性的差异。方法：选择30例孤立性左束支传导阻滞患者纳入对照组。选择32例ICM伴CLBBB心衰患者纳入病例组。应用定量组织速度成像（QTVI）技术测定左室前后间隔、侧壁、前壁及下壁、后壁基底段及中间段共约12节段沿左室长轴运动的收缩期达峰值时间的标准差（Ts-SD），M超测定胸骨旁长轴方向室间隔与左室后壁的时间延迟（SPWMD），脉冲多普勒测定左右心室射血前时间差（IVMD）。结果：与对照组相比，病例组Ts-SD、SPWMD、IVMD明显增大（P＜0.001）。线性相关分析发现，左室内及左右心室间运动不同步与左室大小、QRS波宽度及N末端脑钠肽前体（NT-proBNP）浓度呈正相关。结论：ICM伴CLBBB患者左心室内及左右心室间运动存在明显的不同步性。超声技术在评价心室运动不同步方面具有一定价值。
목적：응용초성심동도기술비교고립성좌속지전도조체환자여결혈성심기병（ICM）반완전성좌속지전도조체（CLBBB）환자좌심실내、좌우심실간수축운동동보성적차이。방법：선택30례고립성좌속지전도조체환자납입대조조。선택32례ICM반CLBBB심쇠환자납입병례조。응용정량조직속도성상（QTVI）기술측정좌실전후간격、측벽、전벽급하벽、후벽기저단급중간단공약12절단연좌실장축운동적수축기체봉치시간적표준차（Ts-SD），M초측정흉골방장축방향실간격여좌실후벽적시간연지（SPWMD），맥충다보륵측정좌우심실사혈전시간차（IVMD）。결과：여대조조상비，병례조Ts-SD、SPWMD、IVMD명현증대（P＜0.001）。선성상관분석발현，좌실내급좌우심실간운동불동보여좌실대소、QRS파관도급N말단뇌납태전체（NT-proBNP）농도정정상관。결론：ICM반CLBBB환자좌심실내급좌우심실간운동존재명현적불동보성。초성기술재평개심실운동불동보방면구유일정개치。
Objective: To identify the difference of left ventricular and interventricular synchronicity found on echocardiogram between patients with ischemic cardiomyopathy (ICM) accompanied with complete left bundle branch block (CLBBB) and those with isolated left bundle branch block.Methods: Thirty-two patients with ICM accompanied with CLBBB (the study group) and 30 patients with isolated left bundle branch block (the control group) were enrolled. The standard deviation of systolic peak time (Ts-SD) in 12 segments along the long axis of left ventricular motion, including the left ventricular septal, the lateral wall, the anterior wall, the inferior wall, the posterior wall of basal segment and the middle segment were evaluated by quantitative tissue velocity imaging (QTVI). The septal-to-posterior wall motion delay (SPWMD) in parasternal long axis was as-sessed by M-mode echocardiogram. The interventricular mechanical delay (IVMD) of left and right ventricle was measured by pulse Doppler.Results: Compared with the control group, Ts-SD, SPWMD and IVMD in the study group were increased signiifcantly (P<0.001). The results of linear correlation analysis indicated that the left ven-tricular and interventricular synchronicity was positively correlated with the size of ventricle, the width of QRS wave and N terminal pro brain natriuretic peptide (NT-proBNP).Conclusion: Patients with ICM accompanied with CLBBB have obvious left ventricular and interventricular dyssynchrony. Echocardiogram is valuable in the assessment of ventricular dyssynchrony.