论文部分内容阅读
目的:应用实时三维超声心动图及其定量技术,分析右室不同部位起搏即刻左室收缩同步性和收缩功能的变化。方法:建立犬右室心尖部(RVA)(n=6)和右室流出道(RVOT)(n=6)起搏模型,分别采集窦性心律(SR)、RVA及RVOT起搏3种状态下经胸超声心动图实时三维全容积图(RT-3DE)。应用左室定量容积分析软件,获取左室整体及16节段容积时间曲线,分别计算16节段、12节段(中间段和基底段)、6节段(基底段)最小收缩容积到QRS波起始点时间(Tmsv)的标准差(Tmsv-SD)和最大差值的绝对值(Tmsv-Dif)及其占心动周期的百分比(Tmsv-SD%,Tmsv-Dif%)、左室舒张末容积(EDV)、左室收缩末容积(ESV)、左室每搏输出量(SV),左室射血分数(LVEF)。结果:与SR组比较,RVOT起搏组各参数均无统计学差异(P>0.05),RVA起搏组Tmsv-16SD%、Tmsv-12SD%、Tmsv-6SD%、Tmsv-16Dif%、Tmsv-12Dif%、Tmsv-6Dif%均有统计学差异(P<0.01),LVEF明显降低(P<0.05),EDV及SV减小、ESV增大,但差异无统计学意义(P>0.05)。RVA起搏组与RVOT起搏组比较Tmsv-16SD%、Tmsv-12SD%、Tmsv-6SD%、Tmsv-16Dif%、Tmsv-12Dif%、Tmsv-6Dif%均有统计学差异(P<0.05),且LVEF降低明显(P<0.05),EDV、SV降低,ESV增大,但差异无统计学意义(P>0.05)。结论:右室流出道起搏时左室收缩同步性优于右室心尖部起搏,且对左室收缩功能的影响小。实时三维超声心动图可用于评价左室心肌收缩同步性和心功能。
OBJECTIVE: To analyze the changes of left ventricular systolic and systolic function immediately after pacing in different parts of the right ventricle by real-time three-dimensional echocardiography and its quantification technique. Methods: The right ventricular apical (RVA) (n = 6) and right ventricular outflow (RVOT) (n = 6) pacing models were established. Three types of sinus rhythm (SR), RVA and RVOT pacing Lower thoracic echocardiography real-time three-dimensional volumetric chart (RT-3DE). Left ventricular volume and volume curve of 16 segments were obtained by using left ventricular quantitative volume analysis software. The minimum systolic volumes of 16 segments, 12 segments (middle segment and basal segment) and 6 segments (basal segment) were calculated to QRS waves (Tmsv-SD) and absolute difference (Tmsv-Dif) of the maximum difference and its percentage of cardiac cycle (Tmsv-SD%, Tmsv-Dif%), left ventricular end-diastolic volume EDV, ESV, SV and LVEF were measured. Results: Compared with the SR group, there was no significant difference in RVOT pacing group (P> 0.05). There was no significant difference between the RVOT pacing group and the RVA pacing group (P> 0.05). The Tmsv-16SD%, Tmsv-12SD%, Tmsv-6SD%, Tmsv-16Dif% (P <0.01), LVEF (P <0.05), EDV and SV decreased, ESV increased, but the difference was not statistically significant (P> 0.05) .2. Tmsv-16SD%, Tmsv-12SD%, Tmsv-6SD%, Tmsv-16Dif%, Tmsv-12Dif% and Tmsv-6Dif% were significantly different between RVA pacing group and RVOT pacing group (P < LVEF decreased significantly (P <0.05), EDV, SV decreased, ESV increased, but the difference was not statistically significant (P> 0.05). Conclusions: Synchronization of left ventricular systole during right ventricular outflow tract pacing is superior to right ventricular apical pacing and has little effect on left ventricular systolic function. Real-time three-dimensional echocardiography can be used to assess left ventricular systolic synchrony and cardiac function.