Synchronicity of Right Ventricular Apex Pacing and Right Ventricular Outflow Tract Evaluated by Tissue Doppler Imaging_West China Medical Journal

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Ultrasound Department of Leshan Hospital, Leshan,Sichuan 614000, P. R. China;

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Keywords：

组织多普勒; 右心起搏; 左室; 收缩同步性

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【摘要】目的 采用组织多普勒成像（TDI）检测右室心尖部起搏（RVAP）、右室流出道起搏（RVOTP）对于左室同步性的影响与比较。方法 2008年3月-2010年3月20例安置RVAP患者及20例安置RVOTP患者术后3个月行TDI检测，将左室12节段收缩达峰时间的标准差（TS-SD）、6个基底段收缩达峰时间差值、左室12个节段中任意两个节段收缩达峰时间最大差值作为同步化参数。结果 TDI结果显示，两组之间同步性参数比较，有统计学意义（P lt;0.01）。结论 RVAP会导致左室内收缩不同步，TDI技术可以准确评价左室收缩同步性。
【Abstract】 Objective To explore the impact of right ventricular apex pacing (RVAP) and right ventricular outflow tract pace-making (RVOTP) on left ventricular systolic synchronization (LVSS) via tissue Doppler imaging (TDI). Methods A total of 20 patients with RVAP and 20 patients with RVOTP from March 2008 to March 2010 were collected. TDI detection was performed on all the patients three months after the operation. Synchronizing parameters included TS-SD of 12 regional contractions of left ventricle, 6 TS difference of basal segment, and maximum difference of TS in 12 regional contractions of left ventricle. Results The results of TDI showed significant difference in synchronizing parameters between RVAP and RVOTP (P lt;0.01). Conclusion RVAP may lead to un-synchronization of the left systole. TDI can evaluate LVSS accurately.

Citation： YANG Li,HU Shuwen,TANG Rong,LUO Xuanwen,LIU Ying,LI Ling,DENG Lili. Synchronicity of Right Ventricular Apex Pacing and Right Ventricular Outflow Tract Evaluated by Tissue Doppler Imaging. West China Medical Journal, 2010, 25(9): 1680-1682. doi: Copy

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1. Petrac D, Radicc B, Radeljic V, et al. lmpact of atrioventricular node ablation and pacing therapy on clinical course in patients with permanent atrial fibrillation and unstable ventricular tachycardia induced by rapid ventricular response: follow-up study[J]. Croat Med J, 2005, 46(6): 929-935.
2. Manolis AS. The deleterious consequences of right ventricular apical pacing: time to seek alternate site pacing[J]. Pacing Clin Electrophysiol, 2006, 29(3): 928-315.
3. Schmidt M, Bromsen J, Herholz C, et al. Evidence of left ventricular dyssynchrony resulting from right ventricular pacing in patients with severely depressed left ventricular ejection fraction[J]. Europace, 2007, 9(1): 34-40.
4. Yu CM, Fung WH, Lin H, et al. Predictors of left ventricular reverse remodeling after cardiac resynchronization therapy for heart failure secondary to idiopathic dilated or ischemic cardiomyopathy[J]. Am J Cardiol, 2003, 91(6): 684-688.
5. Friedlberg MK, Silverman NH, Dubin AM, et al. Mechanical dys-synchrony in children with systolic dysfunction secondary to cardiomyopathy: a Doppler tissue and vector velocity imaging study[J]. J Am Soc Echocardiogr, 2007, 20(6): 756-763.
6. Yu CM, Sanderson JE, Marwick TH, et al. Tissue Doppler imaging: a new prognosticator for cardiovascular diseases[J]. J Am Coll Cardiol, 2007, 49(19): 1903-1914.
7. Yu CM, Lin H, Zhang Q. High prevalence of left ventricular systolie and diastolie asynchrony in patienls with eongestive heart failure adn nomal QRS duration[J]. Heart, 2003, 89(1): 54.
8. Yu CM, Fung WH, Zhang Q, et al. Tissue Doppler Imaging is superior to strain rate imaging and postsystolie shortening in the predictoon of reverse remodeling in both isehemie and nonisehemie heart faihure after eanliar resynehrunization therapy[J]. Circulation, 2004, 110(1): 66.
9. 马树人, 蒙涛, 鲍智, 等. 组织多普勒评价右室心尖部起搏和右室间隔部起搏对心脏血流动力学的影响[J]. 南京医科大学学报, 2009, 29(11): 1567-1569.
10. 洪云飞, 李易, 陶四明, 等. 右心室流出道间隔部起搏和右心室心尖部起搏对血流动力学的影响[J]. 临床荟萃, 2007, 22(9): 640-641.
11. 史浩颖, 汪芳, 孟伟栋, 等. 组织多普勒评价右室不同部位起搏对左室收缩功能和同步性的影响[J]. 中华心血管病杂志, 2005, 33(11): 1002-1005.
12. 马春燕, 任卫东, 唐力, 等. 组织多普勒成像评价DDD型右室心尖部起搏的左室收缩同步性和收缩功能的关系[J]. 中国超声医学杂志, 2008, 24(7): 614-616.

West China Medical Journal

Synchronicity of Right Ventricular Apex Pacing and Right Ventricular Outflow Tract Evaluated by Tissue Doppler Imaging

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