全方向M型超声评价右心室流出道起源室性期前收缩患者左心室运动同步性

摘要

Objective To evaluate the left ventricular radial synchronicity in patients with premature ventricular beats ( PVB ) from right ventricular outflow tract (RVOT ) with omni-directional M-mode echocardiography ( OME ). Methods Two groups were involved in this study including PVB group ( n＝ 30, patients with PVB from RVOT ) and control group ( n＝30 healthy subjects ). The time to peak myocardial systolic velocities ( Ts ) and the time to peak myocardial early-diastolic velocities (Td ) were obtained from the velocity-time curves of 6 segments of the left ventricular short axis view at the level of papillary muscles by OME. The standard deviation of Ts and Td ( Ts-6-SD , Ts-6-SD ) were used as the indicators of left ventricular dyssynchrony. Results Compared with the control group, Ts-6-SD and Td-6-SD were significantly longer than those in PVB group with the normal sinus beat ( P ＜ 0. 05 ),Compared with the normal sinus beat , Ts , Td , Ts-6-SD and Td-6-SD were significantly longer in PVB group( P ＜0. 01 ). Conclusion The PVBs from RVOT could significantly influence left ventricular systolic and diastolic synchrony. The omni-directional M-mode echocardiography is a new way to quantitatively assess the radial synchrony of the left ventricle.%目的 探讨全方向M型超声心动图评价右心室流出道(RVOT) 起源室性期前收缩(PVB)患者左心室心肌径向运动同步性的临床价值.方法 对30例右心室流出道起源PVB患者(PVB组)和30例健康志愿者(对照组),应用全方向M型超声系统测量左心室短轴乳头肌水平6个节段收缩期速度达峰时间(Ts)及舒张早期速度达峰时间(Td),计算6个节段的标准时间差(Ts-6-SD, Td-6-SD),以评价PVB对左心室运动同步性的影响.结果 在所有节段中, PVB组正常窦性心律时Ts、Td与对照组比较,差异无统计学意义(P＞0.05),而 Ts-6-SD、 Td-6-SD均大于对照组(P＜0.05), PVB组PVB时的Ts、 Td、Ts-6-SD、 Td-6-SD均大于正常窦性心律时(P＜0.01).结论 右心室流出道起源PVB患者在窦性心律及PVB时左心室收缩与舒张均存在失同步,全方向M型超声能够为评价左心室心肌径向运动同步性提供一定的参考价值.