超声心动图定量组织速度成像技术对心脏再同步治疗后右心室功能的判定价值

摘要

目的 应用超声心动图定量组织速度成像技术(QTVI)评价慢性心力衰竭(CHF)患者应用心脏再同步治疗(CRT)后右心功能及同步性变化.方法 接受CRT患者22例,在CRT术前、术后1周及6个月用常规超声心动图测量左心室功能、右心室功能及同步性参数,通过QTVI技术测量右心室游离壁的三尖瓣环处的右心室等容舒张时间(RVIRT)、等容收缩时间(RVICT)及射血时间(RVET),并计算右心室心肌功能指数(RV-MPI).结果 ①术后6个月右心室舒张末期面积(RVEDA)、右心室收缩末期面积(RVESA)较术前明显减小(P＜0.05)；右心室面积变化率(RVFAC)及左心室射血分数(LVEF)在术后1周及6个月均不同程度提高(P＜0.05)；②术后1周室间机械延迟时间(IVMD)明显减低(P＜0.05),表明术后1周左、右心室间同步性即明显改善；③术后1周及6个月右心室的RVICT、右心室等容舒张时间(RVIRT)明显缩短(P＜0.05),RVET明显延长(P＜0.01),RV-MPI明显改善(P＜0.01).结论 QTVI可应用于心力衰竭患者右心室功能评测,CRT可改善慢性心力衰竭患者的心室同步性及右心室功能.%Objective To evaluate right ventricular(RV) function and dyssynchrony for patients of chronic heart failure (CHF) with cardiac resynchronization therapy (CRT) by using quantitative tissue velocity imaging technology (QTVI).Methods Twenty-two patients with CRT were included in the study.Some routine ultrasonic parameters and RV isovolumetric contraction time (ICT),isovolumetric relaxation time (IRT) and ejection time (ET) at tricuspid annulus of right ventricular free by QTVI wall were measured and RV global myocardial performance index (RV-MPI) were calculated before and one week and six months after CRT implantation.Results (①Compared with pre-CRT,LVEDA and LVESA were significantly decreased until six months after implantation (P＜0.05).RVFAC and LVEF had improved respectively one week and six months after implantation (P＜0.05).②Compared with pre-CRT,IVMD was significantly decreased one week and six months after CRT (P＜0.05).③RVICT and RVIRT were longer while RVET was shorter and RV-MPI was significantly improved one week and six months after implantation (P＜0.05).Conclusion QTVI was useful in assessing the right ventricular function in patients with chronic heart failure,and CRT can improve the bi-ventricular mechanical synchrony and right ventricular function.