目的 应用二维斑点追踪技术研究双腔起搏器患者左心室旋转与扭转运动的特征,以探讨左心室心肌收缩功能.方法 40例安置起搏器术后7d的病态窦房结综合征患者(起搏器组)和40例健康体检人群(对照组),获取左心室短轴心底水平、心尖水平二维图像,测量左心室短轴二水平收缩期峰值旋转角度,计算峰值扭转角度.结果 收缩期峰值旋转及扭转角度比较:起搏器组心底水平左心室前室间隔(-1.3°±2.4°.)、侧壁(-8.3°±2.2°)、后室间隔(-7.0°±2.5°),心肌峰值旋转角度较正常对照组减低[(-7.1°±2.9°)、(-12.0°±2.5°)、(-11.7°±2.5°)](均为P＜0.05),心尖水平前室间隔(11.1 °±3.2°)、下壁(10.4°±2.7°)、后室间隔(10.0°±3.3°).心肌峰值旋转角度较正常对照组[(6.5°±2.7°)、(7.3°±2.8°)、(7.0°±2.1°)]增强(均为P＜0.05).心底部峰值旋转角度减低,心尖部心肌峰值旋转角度增强(均为P＜0.05),左心室扭转角度无明显差异.结论 起搏器术后左心室存在局部心肌收缩功能变化,超声斑点追踪技术对于旋转与扭转运动的研究,为临床心功能的变化提供依据.%Objective To evaluate left ventricular (LV) rotation and torsion and investigate LV systolic function in patients with the dual-chamber pacemaker by two-dimensional speckle tracking imaging (2D-STI).Methods A total of 40 sick sinus syndrome patients with pacemaker implantation and 40 normal controls were studied.Two dimensional images were collected from LV short views at the basal level and the apical level,and the parameters of rotation and torsion were calculated using 2D-STI.Results The peak rotations of LV septal (-1.3° ± 2.4°),lateral wall (-8.3° ± 2.2°) and posterior septal (-7.0° ±2.5°) were significantly lower at the basal level,and those of LV septal (11.1° ± 3.2°),inferior wall (10.4° ±2.7°) and posterior septal (10.0° ± 3.3°) were significantly increased at the apical level in pacemaker group than in control group (all P ＜ 0.05).Conclusions LV regional wall systolic function in patients implanted dual-chamber pacemaker can be evaluated by 2D-STI.
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