[1]王秀秀 熊峰 邓晓奇 王淑珍 严霜霜 谭焜月 张丽娟.二维斑点追踪成像联合组织多普勒成像技术评价左束支起搏术后早期室间同步性[J].心血管病学进展,2022,(1):88-92.[doi:10.16806/j.cnki.issn.1004-3934.2022.01.022]
 WANG Xiuxiu,XIONG Feng,DENG Xiaoqi,et al.Evaluation of Interventricular Synchrony of Left Bundle Branch Pacing by Two-Dimensional Speckle Tracking Imaging and Tissue Doppler Imaging Technique[J].Advances in Cardiovascular Diseases,2022,(1):88-92.[doi:10.16806/j.cnki.issn.1004-3934.2022.01.022]
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二维斑点追踪成像联合组织多普勒成像技术评价左束支起搏术后早期室间同步性()
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《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2022年1期
页码:
88-92
栏目:
出版日期:
2022-01-25

文章信息/Info

Title:
Evaluation of Interventricular Synchrony of Left Bundle Branch Pacing by Two-Dimensional Speckle Tracking Imaging and Tissue Doppler Imaging Technique
作者:
王秀秀 熊峰 邓晓奇 王淑珍 严霜霜 谭焜月 张丽娟
西南交通大学附属医院 成都市第三人民医院心内科 成都市心血管病研究所,四川 成都 610031
Author(s):
WANG XiuxiuXIONG FengDENG XiaoqiWANG ShuzhenYAN ShuangshuangTAN KunyueZHANG Lijuan
The Affiliated Hospital of Southwest Jiaotong University,Department of Cardiology of The Third People’s Hospital of Chengdu,Cardiovascular Institute of Chengdu,Chengdu610031,Sichuan,China
关键词:
斑点追踪成像组织多普勒成像左束支起搏室间同步性机械同步性
Keywords:
Speckle tracking imagingTissue Doppler imagingLeft bundle branch pacingInterventricular synchronizationMechanical synchronization
DOI:
10.16806/j.cnki.issn.1004-3934.2022.01.022
文献标志码:
A
摘要:
目的采用二维斑点追踪成像联合组织多普勒成像技术对左束支起搏术后早期室间同步性进行评价,比较两种方法评价室间同步性的效果。方法 选取2019年5月—2020年5月于成都市第三人民医院心内科行左束支起搏的患者30例作为病例组,行右室流出道起搏的患者24例作为对照组。术后1个月行经胸超声心动图检查,采集至少三个心动周期的心尖四腔切面二维及组织多普勒动态图像,通过二维斑点追踪技术绘制左室侧壁、右室游离壁应变-时间曲线,记录基底段2个节段纵向应变达峰时间;通过组织多普勒技术绘制左室侧壁、右室游离壁基底段速度-时间曲线,记录基底段2个节段收缩速度达峰时间。两种方法均采用两侧室壁基底段达峰时间差值的绝对值作为室间同步性参数。比较两种起搏方式的室间同步性和两种方法的检测结果。结果 两组常规超声心动图参数相比较,差异无统计学意义(P>0.05)。两组二维斑点追踪成像法室间同步性参数相比较,差异有统计学意义(P<0.05),组织多普勒成像法室间同步性参数相比较,差异无统计学意义(P>0.05)。两种方法的室间同步性参数存在正相关关系(相关系数0.392,P<0.05)。两种方法对左束支起搏组的室间同步性检测阳性率结果相比差异有统计学意义(P<0.05),而对右室流出道起搏组检测阳性率结果相比差异无统计学意义(P>0.05)。结论 左束支起搏术后早期室间同步性优于右室流出道起搏。使用二维斑点追踪技术可对左束支起搏室间同步性做出快速评价,且优于组织多普勒技术。
Abstract:
Objective To evaluate interventricular synchronization in patients with left bundle branch pacing(LBBP) by two-dimensional speckle trackingimaging(2D-STI) and tissue Doppler imaging(TDI),and compare the outcomes of interventricular synchronization parameters by two methods. Methods30 patients with LBBP in Department of Cardiology of The Third People’s Hospital of Chengdu from May 2019 to May 2020 were selected as the case group,and 24 patients with right ventricular outflow tract pacing(RVOTP) in the same period were selected as the control group. One month after operation,transthoracic echocardiography was performed,and two-dimensional and TDI images of apical four chamber view for at least three consecutive cardiac cycles were collected. The strain-time curves of left and right ventricular walls were generated by 2D-STI,and the time to peak(Ts) of longitudinal strain of basal segments were recorded. The velocity-time curves of 2 basal segments of left and right ventricular walls were generated by TDI, and Ts of contraction velocity of 2 basal segments were recorded. The absolute value of the differencesbetween Ts of basal segments of right and left ventricular walls was used as the interventricular synchronization parameter. Interventricular synchronization of two pacing modes and outcomes of two methods were compared. ResultsThere was no significant difference in conventional echocardiographic parameters between the two groups(P> 0.05). There was significant difference in ventricular synchronization parameters between the two groups by 2D-STI(P<0.05),and there was no significant difference in ventricular synchronization parameters by TDI(P>0.05). There was a positive correlation between the ventricular synchronization parameters of the two methods(correlation coefficient 0.392, P<0.05). There was significant difference in the positive rate of ventricular synchrony between the two methods in the LBBP group(P<0.05), but there was no significant difference in the positive rate of ventricular synchrony between the two methods in the RVOTP group(P>0.05). ConclusionThe interventricular synchronization of LBBP is better than RVOTP in the early postoperative period. 2D-STI can quickly evaluate the interventricular synchronization of LBBP and is better than TDI.

参考文献/References:

[1] Huang W,Su L,Wu S,et al. A novel pacing strategy with low and stable output:pacing the left bundle branch immediately beyond the conduction block[J]. Can J Cardiol,2017,33(12):1736.e1-1736.e3.

[2] Huang W,Wu S,Vijayaraman P,et al. Cardiac resynchronization therapy in patients with nonischemic cardiomyopathy using left bundle branch pacing[J]. JACC Clin Electrophysiol,2020,6(7):849-858.
[3] Vijayaraman P,Sundaram S,Cano ó,et al. Left bundle branch area pacing for cardiac resynchronization therapy:results from the international LBBAP collaborative study group[J]. JACC Clin Electrophysiol,2021,7(2):135-147.
[4] 王淑珍,邓晓奇,熊峰,等. 左束支起搏患者心脏机械同步性的早期评估[J]. 中国循环杂志,2021,36(1):28-33.
[5] 蔡彬妮,李琳琳,黄心怡,等. 左束支起搏的心脏电学和机械同步性及中远期导线稳定性研究[J]. 中国循环杂志,2020,35(1):55-61.
[6] 黄心怡,蔡彬妮,李琳琳,等. 组织多普勒技术评价左束支区域起搏对心脏收缩同步性的影响[J]. 中华超声影像学杂志,2019,28(4):289-294.
[7] Liu BY,Wu WC,Zeng QX,et al. Two-dimensional speckle tracking echocardiography detected interventricular dyssynchrony predicts exercise capacity and disease severity in pre-capillary pulmonary hypertension[J]. Ann Transl Med,2020,8(7):456.
[8] Kusumoto FM,Schoenfeld MH,Barrett C,et al. 2018 ACC/AHA/HRS guideline on the evaluation and management of patients with bradycardia and cardiac conduction delay:a report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines and the Heart Rhythm Society[J]. J Am Coll Cardiol,2019,74(7):e51-e156.
[9] 李治安,张烨. 心室同步化运动的超声心动图评价[J].中华医学超声杂志(电子版),2006,3(3):131-136.
[10] Karpawich PP,Justice CD,Cavitt DL,et al. Developmental sequelae of fixed-rate ventricular pacing in the immature canine heart:an electrophysiologic,hemodynamic,and histopathologic evaluation[J]. Am Heart J,1990,119(5):1077-1083.
[11] Zou C,Song J,Li H,et al. Right ventricular outflow tract septal pacing is superior to right ventricular apical pacing[J]. J Am Heart Assoc,2015,4(4):e001777.
[12]Guo J,Li L,Meng F,et al. Short-term and intermediate-term performance and safety of left bundle branch pacing[J]. J Cardiovasc Electrophysiol,2020,31(6):1472-1481.
[13] Li Y,Chen K,Dai Y,et al. Left bundle branch pacing for symptomatic bradycardia:implant success rate,safety,and pacing characteristics[J]. Heart Rhythm,2019,16(12):1758-1765.
[14] Wang S,Wu S,Xu L,et al. Feasibility and efficacy of His bundle pacing or left bundle pacing combined with atrioventricular node ablation in patients with persistent atrial fibrillation and implantable cardioverter-defibrillator therapy[J]. J Am Heart Assoc,2019,8(24):e014253.
[15] 宋爱萍,任骋,徐心纯,等. 超声心动图评价左束支区域起搏与右心室起搏对左心室收缩同步性的影响[J]. 中国医学影像学杂志,2021,29(2):152-157.

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备注/Memo

备注/Memo:
基金项目:四川省卫生健康委员会基金(20PJ210)
通信作者:熊峰,E-mail:xiong.feng05@163.com
更新日期/Last Update: 2022-02-18