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预激综合征患者旁路的无创定位:应变成像研究

Noninvasive localization of accessory pathways in patients with wolff-Parkinson-white syndrome: a strain imaging study.

作者信息

Esmaeilzadeh Maryam, Omran Mohammad Taghi Salehi, Maleki Majid, Haghjoo Majid, Noohi Feridoun, Haghighi Zahra Ojaghi, Sadeghpour Anita, Davari Paridokht Nakhostin, Abkenar Hooman Bakhshandeh

机构信息

Echocardiography Research Center, Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.

出版信息

J Tehran Heart Cent. 2013 Apr;8(2):65-9. Epub 2013 Apr 28.

Abstract

BACKGROUND

Noninvasive techniques for the localization of the accessory pathways (APs) might help guide mapping procedures and ablation techniques. We sought to examine the diagnostic accuracy of strain imaging for the localization of the APs in Wolff-Parkinson-White syndrome.

METHODS

We prospectively studied 25 patients (mean age = 32 ± 17 years, 58.3% men) with evidence of pre-excitation on electrocardiography (ECG). Electromechanical interval was defined as the time difference between the onset of delta wave and the onset of regional myocardial contraction. Time differences between the onset of delta wave (δ) and the onset of regional myocardial contraction (δ-So), peak systolic motion (δ-Sm), regional strain (δ-ε), peak strain (δ-εp), and peak strain rate (δ-SRp) were measured.

RESULTS

There was a significant difference between time to onset of delta wave to onset of peak systolic motion (mean ± SD) in the AP location (A) and normal segments (B) versus that in the normal volunteers (C) [A: (57.08 ± 23.88 msec) vs. B: (75.20 ± 14.75) vs. C: (72.9 0 ± 11.16); p value (A vs. B) = 0.004 and p value (A vs. C) = 0.18] and [A: (49.17 ± 35.79) vs. B: (67.60 ± 14.51) vs. C: (67.40 ± 6.06 msec); p value (A vs. B) < 0.001 and p value (A vs. C) = 0.12, respectively].

CONCLUSION

Our study showed that strain imaging parameters [(δ-So) and (δ-Strain)] are superior to the ECG in the localization of the APs (84% vs. 76%).

摘要

背景

用于辅助通路(APs)定位的非侵入性技术可能有助于指导标测程序和消融技术。我们试图研究应变成像在预激综合征中辅助通路定位的诊断准确性。

方法

我们前瞻性地研究了25例心电图(ECG)有预激证据的患者(平均年龄=32±17岁,男性占58.3%)。机电间期定义为δ波起始与局部心肌收缩起始之间的时间差。测量了δ波起始(δ)与局部心肌收缩起始(δ-So)、收缩期峰值运动(δ-Sm)、局部应变(δ-ε)、峰值应变(δ-εp)和峰值应变率(δ-SRp)之间的时间差。

结果

辅助通路所在部位(A)和正常节段(B)与正常志愿者(C)相比,从δ波起始到收缩期峰值运动起始的时间(平均值±标准差)存在显著差异[A:(57.08±23.88毫秒) vs. B:(75.20±14.75) vs. C:(72.90±11.16);p值(A vs. B)=0.004,p值(A vs. C)=0.18]以及[A:(49.17±35.79) vs. B:(67.60±14.51) vs. C:(67.40±6.06毫秒);p值(A vs. B)<0.001,p值(A vs. C)分别为0.12]。

结论

我们的研究表明,应变成像参数[(δ-So)和(δ-应变)]在辅助通路定位方面优于心电图(84%对76%)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d24/3740111/fcd1b67ce7a4/jthc-8-65f1.jpg

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