Sade L Elif, Kanzaki Hideaki, Severyn Donald, Dohi Kaoru, Gorcsan John
Division of Cardiology, University of Pittsburgh, 200 Lothrop Street, Pittsburgh, PA 15213-2582, USA.
Am J Cardiol. 2004 Aug 15;94(4):514-8. doi: 10.1016/j.amjcard.2004.04.071.
Cardiac resynchronization therapy has made assessment of cardiac dyssynchrony clinically important. To test the hypothesis that echocardiographic displacement imaging can quantify dyssynchrony, 22 patients with left bundle branch block (LBBB), 14 with idiopathic dilated cardiomyopathy (IDC) without electrical conduction delay, and 22 normal controls were studied using radial angle-corrected displacement imaging. Control subjects had coordinated wall movement, whereas patients with LBBB had dyssynchrony characterized by early inward anteroseptal movement and markedly delayed posterior, lateral, or inferior regions (157 +/- 99 ms; p <0.001 vs normal). An interesting subset of patients with IDC without conduction delay (36%) had dyssynchrony with anteroseptal to posterior wall delays of 169 +/- 56 ms (p <0.001 vs normal), similar to patients with LBBB.
心脏再同步治疗使得心脏不同步的评估在临床上变得重要。为了验证超声心动图位移成像能够量化不同步这一假设，我们使用径向角度校正位移成像对22例左束支传导阻滞（LBBB）患者、14例无电传导延迟的特发性扩张型心肌病（IDC）患者以及22名正常对照者进行了研究。对照者的室壁运动协调，而LBBB患者存在不同步，其特征为前间隔早期向内运动，而后壁、侧壁或下壁运动明显延迟（157±99毫秒；与正常组相比，p<0.001）。一个有趣的现象是，无传导延迟的IDC患者中有一部分（36%）存在不同步，前间隔至后壁延迟为169±56毫秒（与正常组相比，p<0.001），这与LBBB患者相似。
