左束支传导阻滞对左心室容积、射血分数和局部室壁运动的影响。
Influence of left bundle branch block on left ventricular volumes, ejection fraction and regional wall motion.
机构信息
Department of Cardiology, Hilversum Hospital, Hilversum, the Netherlands.
出版信息
Neth Heart J. 2007;15(3):89-94. doi: 10.1007/BF03085961.
BACKGROUND.: Left ventricular volumes, ejection fraction and regional wall motion are cardiac parameters which provide valuable information for patient management in a large variety of cardiac conditions. Differences in regional wall motion are of relevance in the field of cardiac resynchronisation therapy. We quantified three-dimensional echocardiographic measurements of left ventricular volumes, ejection and regional wall motion (e.g. expressed as systolic dyssynchrony index (SDI)) in two patient cohorts: patients with normal conduction and patients with complete left bundle branch block. METHODS.: Thirty-five patients scheduled for routine cardiac examination underwent three-dimensional echocardiography: 23 patients with normal conduction and 12 patients with a complete left bundle branch block. Full-volume datasets were analysed and end-systolic volume (ESV), end-diastolic volume (EDV) and ejection fraction (EF) were obtained. SDI was derived from the standard deviation of the measured times to reach minimal regional volume for each of the 16 segments of the left ventricle. RESULTS.: A significant difference was observed in left ventricular volumes, ejection fraction and SDI between the two groups. Patients with complete left bundle branch block showed higher EDV (p=0.025) and ESV (p<0.01) and a lower EF (p<0.01) than patients with normal conduction. SDI is significantly higher in patients with complete left bundle branch block (p=0.004) expressing a higher amount of ventricular dyssynchrony. Intraobserver variability showed excellent correlation coefficients: r=0.99 for EDV, ESV and SDI and r=0.98 for EF. CONCLUSION.: Three-dimensional echocardiography is a feasible and reproducible method for the quantification of left ventricular volumes, left ventricular ejection fraction and regional wall motion. Differences can be assessed between normal patients and patients with left bundle branch block. (Neth Heart J 2007;15:89-94.).
背景
左心室容积、射血分数和局部壁运动是心脏参数，为各种心脏疾病的患者管理提供了有价值的信息。局部壁运动的差异在心腔同步治疗领域具有重要意义。我们量化了两个患者队列的左心室容积、射血和局部壁运动的三维超声心动图测量值（例如，用收缩不同步指数（SDI）表示）：正常传导患者和完全左束支传导阻滞患者。方法：35 名接受常规心脏检查的患者接受了三维超声心动图检查：23 名正常传导患者和 12 名完全左束支传导阻滞患者。分析全容积数据集，获得收缩末期容积（ESV）、舒张末期容积（EDV）和射血分数（EF）。SDI 是从左心室 16 个节段中每个节段达到最小局部容积的测量时间的标准差得出的。结果：两组间左心室容积、射血分数和 SDI 存在显著差异。完全左束支传导阻滞患者的 EDV（p=0.025）和 ESV（p<0.01）更高，EF 更低（p<0.01）。完全左束支传导阻滞患者的 SDI 明显更高（p=0.004），表明心室不同步程度更高。观察者内变异性显示出极好的相关系数：EDV、ESV 和 SDI 的 r 值为 0.99，EF 的 r 值为 0.98。结论：三维超声心动图是一种可行且可重复的方法，可用于量化左心室容积、左心室射血分数和局部壁运动。可以评估正常患者和左束支传导阻滞患者之间的差异。（荷兰心脏杂志 2007；15：89-94.）。
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