| 摘要: |
| 【摘要】目的 应用斑点追踪技术结合压力-应变环评估病态窦房结综合征（SSS）伴或不伴阵发性房颤（PAF）患者左室收缩和舒张功能。方法 SSS不伴PAF组37例，SSS伴PAF组25例，体检健康者30例为对照组，常规超声测量左房及右房内径(LA及RA)、左室舒张末及收缩末内径(LVEDs及LVEDd)、二尖瓣口舒张早期和晚期峰值流速(E和A)、等容舒张时间（IVRT）、二尖瓣E峰减速时间(EDT)、二尖瓣环舒张早期峰值速度 (e''),计算E/A、E/e''；测量左室心肌应变及做功参数：整体纵向应变 (GLS)及达峰时间离散度 (PSD)、心肌整体做功指数（GWI)、做功效率(GWE)、有用功(GCW)、无用功 (GWW)；测量扭转角度峰值(Ptw)、扭转速度峰值(PTV)、解旋速度峰值(PUV)、解旋率(UntwR)。结果 ①与对照组比较，SSS不伴PAF组RA、E/e''、IVRT，整体及心尖段的Ptw、PTV，PSD、GWW增大，基底段UntwR、PUV，GWI减小（均P<0.05）；SSS伴PAF组RA、LA、LVEDs、LVESd、E/e''、IVRT增大，LVEF、E/A、EDT，整体、基底段的Ptw、PTV、UntwR、PUV，整体UntwR，GWI、GCW减小（均P<0.05）。②与SSS不伴PAF组比较，SSS伴PAF组LA、LVEDd、LVESd、IVRT、PSD、GWW增大，LVEF、EDT、左室整体和各节段的Ptw、PTV、PUV，整体UntwR，GLS、GWI、GCW、GWE均减小（均P<0.05）。结论 斑点追踪技术与压力-应变环结合可以早期、定量评估SSS伴PAF患者的左室舒张和收缩功能早期受损及其程度。 |
| 关键词: ：超声心动描记术 压力-应变环 左室扭转 病态窦房结综合征 阵发性房颤 |
| DOI： |
| 投稿时间：2021-09-25修订日期：2021-10-19 |
| 基金项目:重庆市科卫联合中医药科研项目(2019ZY023191、2020ZY023614)；重庆市科研院所绩效激励引导专项(cstc2019jxjl130010); |
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| Assessment of left ventricular torsion and myocardial function in patients with sick sinus syndrome with paroxysmal atrial fibrillation by speckle tracking imagingFengxue,Lumin,Tiantian,Xiaofang,Yuanyuan,Yanglusha,Longyi |
| Fengxue,lumin,tiantian,xiaofang,yuanyuan,yanglusha,longyi |
| () |
| Abstract: |
| Objective To evaluate theleft ventricular diastolic and systolic function in patients with sick sinus syndrome (SSS) with or without paroxysmal atrial fibrillation (PAF) by speckle tracking imaging combined with pressure strain loop. Methods A Total of 37 PSS cases were selected as SSS group， 25 cases of PSS combined with PAF as SSS with PAF group，30 healthy subjects as control group.The left and right atrial diameters (LA and RA) ，end-diastolic and -systolic diameters (LVEDs and LVEDd) ，peak velocity of early and late diastolic mitral valve(E and A) ，isovolumic diastolic time (IVRT) ， mitral E-peak deceleration time (EDT)， and early diastolic peak velocity (e'') of mitral annulus were measured by conventional echocardiography， E/A and E/e'' were calculated.The left ventricular myocardial strain and work parameters were measure，including global longitudinal strain (GLS)，peak-time dispersion (PSD) ，global work index（GWI)，global work efficiency (GWE) ，global constructive work (GCW)， global wasted work (GWW).And the peak twist(Ptw)，peak twist velocity(PTV)，peak untwisting velocity(PUV)，untwisting rate(UntwR) were measured.Results ①Compared with the control group， RA，E/e’，IVRT and Ptw、PTV of globe and apical segment，PSD，GWW in SSS group were increased，while UntwR，PUV，GWI of basal segment were decreased(all P<0.05).RA，LA，LVEDs，LVESd，E/e’ and IVRT in SSS with PAF group were increased，while Ptw、PTV、UntwR、PUV of globe and basal segment，and GWI，GCW were decreased(all P<0.05). ②Compared with SSS group，LA，LVEDd，LVESd，IVRT，PSD，GWW in SSS with PAF group were increased，LVEF，EDT and Ptw，PTV，PUV of globe and each segments were decreased，global UntwR，GLS，GWI，GCW，GWE were also decreased(all P<0.05).Conclusion Speckle tracking imaging combined with pressure strain loop can early and quantitatively evaluate the early damage and the degree of left ventricular diastolic and systolic function in SSS combined with PAF patients. |
| Key words: Echocardiography Pressure-strain loop Left ventricular torsion Sick sinus syndrome Paroxysmal atrial fibrillation |
