Objective To explore the role of echocardiography parameters in evaluation of left ventricular diastolic function in elderly patients with normal left ventricular ejection fraction(LVEF) , who were implanted with dual‐chamber pacemaker .Methods The parameters of speckle tacking imaging ,tissue Doppler imaging and color M‐mode Doppler were used to measure left ventricular systolic and diastolic function in 40 elderly patients(group A) with atrial synchronous right ventricular apical pacing(RVAP) and 30 healthy controls(group C) .Plasma B‐type natriuretic peptide(BNP) was detected by ELISA in two groups .The patients were followed‐up for one year .Results Compared to group C after one year ,the ratio of early diastolic transmitral inflow velocity to late diastolic transmitral inflow velocity ,peak early mitral annular diastolic velocity [at septal wall ,at lateral wall and the mean value(Ea mean)] ,global early diastolic strain rate and early diastolic flow propagation velocity were decreased ,but QRS duration ,E/Ea mean and BNP were increased ,and isovolumetric relaxation time was prolonged(P<0 .05 and P<0 .01) .Multiple linear regression model in group A showed that age ,Ea mean and E/Ea mean were the independent factors related to plasma BNP (P<0 .05) .Conclusion After dual‐chamber pacemaker implantation in elderly patients ,RVAP increases the damage of left ventricular diastolic function .Ea mean and E/Ea mean can be the important indicators in evaluating left ventricular diastolic dysfunction .%目的：探讨超声心动图参数评估左心室射血分数（LVEF）正常老年患者植入双腔起搏器后的左室舒张功能。方法应用斑点追踪、组织多普勒和彩色M 型多普勒参数测量40例LVEF正常的植入双腔起搏器右室心尖起搏（RVA P ）老年患者（A组）和30例健康体检老年人（C组）的左室收缩和舒张功能；ELISA法检测血浆B型钠尿肽（BNP）水平。随访1年。结果与C组比较，1年后，A组二尖瓣口舒张早期血流峰值／舒张晚期血流峰值、舒张早期二尖瓣环组织运动速度[室间隔侧瓣环峰值速度、外侧瓣环峰值速度及两者平均值（Ea mean）]、整体舒张早期纵向应变率和舒张早期血流播散速度均降低，而QRS波离散度、E／Ea mean和BNP升高，且等容舒张时间延长（P＜0．05或P＜0．01）。A组多元线性回归模型分析显示，年龄、Ea mean、E／Ea mean与BNP水平独立相关（P＜0．05）。结论老年患者植入双腔起搏器后，RVAP加重了左室舒张功能的损害。Ea mean、E／Ea mean参数可作为评估左室舒张功能不全进展的重要指标。
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