Arturi E, Gabrielli F, Rossi M K, Luzzi V, Alcini E
Università degli Studi di Roma, La Sapienza, III Semeiotica Cardiovascolare.
Minerva Cardioangiol. 1990 Apr;38(4):127-34.
24 patients (19 females and 5 males) between 45 and 81 years of age (average age 61.6) with chronic left bundle branch block and with no signs of reduced left ventricular function have been studied by M-Mode echocardiography. These patients have been split into three groups: A) pts. with normal indexes of left ventricular function and normal thickness of the left ventricular walls; B) pts. with normal indexes of left ventricular function and thickness of the interventricular septum at upper limits or increased; C) pts. with different cardiac pathologies but with no signs of reduced ventricular function. The contractility indexes and the motion of the interventricular septum in both the basal and the medial portion have been studied. The results did not show any important variation concerning the ventricular function compared to the normal values. The study of the septal motion pointed out, as a main feature of the left bundle branch block, a preejective posterior motion followed by: a) a normal posterior systolic motion of the interventricular septum, or b) a posterior systolic motion followed by a further posterior protodiastolic motion (delayed motion), or c) an anterior systolic and posterior diastolic motion (paradoxical motion). The alterations of the septal movement ranked in different degrees. The clearest alterations were peculiarly found in the patients of the first group. The patiens of the third group, besides, have shown the lightest alterations. The results allowed to deduce that patients with left bundle branch block can have both normal motion or alterations of the interventricular septum motion of different degree.(ABSTRACT TRUNCATED AT 250 WORDS)
对24例年龄在45至81岁(平均年龄61.6岁)、患有慢性左束支传导阻滞且无左心室功能降低迹象的患者(19例女性和5例男性)进行了M型超声心动图研究。这些患者被分为三组:A组,左心室功能指标正常且左心室壁厚度正常的患者;B组,左心室功能指标正常但室间隔厚度达到上限或增加的患者;C组,患有不同心脏疾病但无心室功能降低迹象的患者。研究了两组患者的收缩性指标以及室间隔基部和中部的运动情况。结果显示,与正常值相比,心室功能没有任何显著变化。对室间隔运动的研究指出,作为左束支传导阻滞的主要特征,存在射血前期向后运动,随后出现:a)室间隔正常的收缩期向后运动;b)收缩期向后运动后接着进一步的舒张前期向后运动(延迟运动);c)收缩期向前和舒张期向后运动(矛盾运动)。室间隔运动的改变程度不同。最明显的改变尤其在第一组患者中发现。此外,第三组患者的改变最轻。结果表明,左束支传导阻滞患者的室间隔运动可能正常,也可能有不同程度的改变。(摘要截选至250词)