| 马春燕,刘爽,任卫东,于波,唐力.二维超声斑点追踪预测充血性心力衰竭患者心脏再同步化治疗的急性期反应[J].中国医学影像技术,2010,26(2):278~281 |
| 二维超声斑点追踪预测充血性心力衰竭患者心脏再同步化治疗的急性期反应 |
| Prediction of acute response to cardiac resynchronization therapy with two-dimensional speckle tracking echocardiography in congestive heart failure patients |
| 投稿时间：2009-08-20 修订日期：2009-10-20 |
| DOI： |
| 中文关键词: 超声心动描记术 再同步化治疗 心力衰竭 |
| 英文关键词:Echocardiography Cardiac resynchronization therapy Heart failure |
| 基金项目:辽宁省教育厅课题(2008748)。 |
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| 中文摘要: |
| 目的 观察二维超声斑点追踪(2D-STE)是否可预测充血性心力衰竭患者心脏再同步化治疗(CRT)的急性期反应。方法 24例充血性心力衰竭患者接受CRT治疗,术后7天分别在CRT关闭(OFF)和开启(ON)状态接受超声检查。将2D-STE测量的左心室短轴前间壁和后壁达峰值径向应变的时间差(TAS-POST )≥130 ms定义为左心室收缩不同步。将CRT-ON时左心室压力最大上升速率(LVdp/dt)的增长率Δdp/dt%＞25%定义为急性反应有效。结果 15例患者(62.50%) CRT有反应,CRT-ON时左心室射血分数和LVdp/dt增大,TAS-POST 缩短。TAS-POST 是预测Δdp/dt%＞25%的独立因素,TAS-POST ≥130 ms预测CRT急性反应的敏感度和特异度分别为86.24%和70.38%。结论 2D-STE技术能够有助于选择CRT最适病例,并预测其急性期反应。 |
| 英文摘要: |
| Objective To assess the value of two-dimensional speckle tracking echocardiography (2D-STE) of predicting the acute response to cardiac resynchronization therapy (CRT) in patients with congestive heart failure. Methods Twenty-four patients with congestive heart failure scheduled for CRT were included. 2D-STE was performed within 7 days of implantation with device ON and OFF. Left ventricular (LV) dyssynchrony was defined as an interval ≥130 ms for the absolute difference in time to peak radial strain for the anteroseptal wall versus the posterior wall (TAS-POST) with 2D-STE. Acute hemodynamic response was measured as LVdp/dt, and percentage change in LVdp/dt was used to classify responders (Δdp/dt%＞25%) and nonresponders (Δdp/dt%≤25%). Results Fifteen patients (62.50%) were classified as acute responders. Compared with nonresponders, the responders demonstrated significant increase of LV ejection fraction and reduction of TAS-POST after CRT-ON. TAS-POST was the only determinants of Δdp/dt%＞25%. TAS-POST≥130 ms prognosticated acute response to CRT with sensitivity of 86.24% and specificity of 70.38%. Conclusion CRT can immediately increase the LV systolic function and synchrony. 2D-STE is highly predictive for acute response to CRT. |
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