| 邹媛,岳文胜,王亚萍,罗勇,吕湛,胡厚祥,张宁,袁玺,安姝.不同起搏模式对左心室功能及左心室短轴应变的影响[J].中国医学影像技术,2014,30(8):1188~1193 |
| 不同起搏模式对左心室功能及左心室短轴应变的影响 |
| Influences on left ventricular function and short axis strain in different cardiac pacing mode |
| 投稿时间：2014-02-03 修订日期：2014-05-26 |
| DOI： |
| 中文关键词: 心室功能 左 径向应变 周向应变 心脏起搏器 斑点追踪技术 |
| 英文关键词:Ventricular function left Radial strain Circumferential strain Cardiac pacemaker Speckle tracking imaging |
| 基金项目:国家自然科学基金（81241056）。 |
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| 中文摘要: |
| 目的 探讨不同心脏起搏模式对具有正常房室传导顺序并植入双腔频率应答起搏器（即DDDR起搏器）的病态窦房结综合征（SSS）患者左心室功能和左心室短轴应变的影响。方法 纳入具有正常房室传导顺序并植入DDDR起搏器的SSS患者45例，对每例患者随机进行心房起搏心室起搏（APVP）、心房起搏心室感知（APVS）和心房感知心室感知（ASVS）模式起搏各30 min，通过超声心动图技术获取患者在3种模式下左心室功能和左室短轴应变参数。结果 3种起搏模式中，ASVS与APVS起搏模式下E/E'低于APVP起搏模式，LVEF和SV高于APVP起搏模式（P<0.05）。收缩期峰值径向应变：ASVS起搏模式下除基底段前间壁外，余基底段各节段及中间段各节段均显著高于APVP起搏模式（P均<0.05），APVS起搏模式下基底段侧壁、后壁、下壁及中间段各节段均显著高于APVP起搏模式（P均<0.05）。ASVS起搏模式下除基底段前间壁和中间段前壁和下壁外，余基底与中间段各节段均高于APVS起搏模式（P均<0.05）。收缩期峰值周向应变：ASVS起搏模式下基底段后壁和下壁和中间段侧壁高于APVP起搏模式，APVS起搏模式下中间段下壁和后间壁、心尖段后壁和下壁高于APVP起搏模式（P均<0.05）。结论 ASVS和APVS起搏模式下能较好地保存心肌收缩能力和维持有效的心排出量。 |
| 英文摘要: |
| Objective To investigate the changes of left ventricular function and short axis strain of sick sinus syndrome (SSS) patients in different cardiac pacing modes as determined by echocardiography. Methods All of 45 SSS patients with normal atrioventricular conduction and previously implanted dual chamber rate response pacemaker (DDDR pacemaker) cardiac pacemaker were enrolled. Every patient was randomized to atrial pacing ventricular pacing (APVP), atrial pacing ventricular sensing (APVS) and atrial sensing ventricular sensing (ASVS) mode pacing 30 min first, and then crossed over to perform the other two pacing modes to work 30 min. Left ventricle ejection fraction (LVEF), stroke volume (SV) and left ventricular filling index (E/E') were observed with echocardiography. Results Among three pacing modes, APVP pacing mode had lower LVEF and SV, higher E/E' than ASVS and APVS pacing mode (P<0.05). Peak systolic radial strain: Except the anterior septum of mitral annular plan, the other segments of mitral annular plane and papillary muscle plane of ASVS pacing mode were significantly higher than APVP pacing mode (P<0.05), APVS pacing mode was significantly higher than APVP pacing mode on lateral wall, posterior and inferior wall of mitral annular plan and all segments of papillary muscle plane (P<0.05), ASVS mode was higher than APVS mode on all segments of both two planes expect anterior septum of mitral annular plane and anterior, inferior wall of papillary muscle plane (P<0.05). Peak circumferential strain: ASVS mode was higher than APVP mode on posterior and inferior wall of mitral annular plane and lateral wall of papillary muscle plane, APVS mode was higher than APVP mode on inferior wall and posterior spetum of papillary muscle plane and posterior, inferior wall of apex plane (P<0.05). Conclusion Both ASVS and APVS pacing modes preserved better myocardial systolic function and effectively kept cardiac output compared with APVP pacing mode. |
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