Ma Li, Li Yanhong, Wu Zhisheng, Mu Yuming
Department of Echocardiography, First Affiliated Hospital, Xinjiang Medical University Urmuqi, China.
Am J Cardiovasc Dis. 2016 Nov 30;6(4):175-184. eCollection 2016.
The aim of this study was to assess the relationship between R-R interval and left ventricular systolic synchrony in subjects with coronary artery disease determined using angiography. A total of 277 subjects who underwent coronary angiography for suspected CAD were recruited in this study. For all subjects, the R-R interval was quantified using simultaneous ECG, and the times to peak systolic longitudinal strain (Tssl) on 17 LV segments were quantified using four-dimensional (4D) speckle tracking echocardiography (STE) and manually measured. The independent predictors of interval using multiple linear regression analyses were the time to peak systolic longitudinal strain in the apical-septal segment (Tssl-Apical-S) (=0.325, =0.000), smoking status (=0.141, =0.013), and the time to peak systolic longitudinal strain in the basal-anterolateral segment (Tssl-Basal-AL) (=0.151, =0.014), which were significantly independently associated with the R-R interval. In multiple regression analyses, smoking status (, 1.943; 95% , 1.119-3.375, =0.018), Tssl-Basal-AL (, 1.002; 95% , 1.000-1.004, =0.043), the time to peak systolic longitudinal strain in the mid-inferoseptal segment (Tssl-Mid-IS) (, 1.008; 95% , 1.003-1.013, =0.004), and Tssl-Apical-S (, 1.010; 95% , 1.004-1.016, =0.002) remained independently associated with the risk of a longer interval (the median 849.49 ms was set as the cutoff value) in the population. Our findings may provide the basis for future investigations of LV systolic synchrony and cardiac resynchronization therapy.
本研究旨在评估经血管造影确定的冠心病患者的R-R间期与左心室收缩同步性之间的关系。本研究共纳入了277例因疑似冠心病而接受冠状动脉造影的患者。对所有受试者,使用同步心电图对R-R间期进行量化,并使用四维(4D)斑点追踪超声心动图(STE)对17个左心室节段的收缩期纵向应变峰值时间(Tssl)进行量化并手动测量。使用多元线性回归分析得出,R-R间期的独立预测因素为心尖-间隔节段的收缩期纵向应变峰值时间(Tssl-Apical-S)(β=0.325,P=0.000)、吸烟状况(β=0.141,P=0.013)以及基底-前外侧节段的收缩期纵向应变峰值时间(Tssl-Basal-AL)(β=0.151,P=0.014),它们均与R-R间期显著独立相关。在多元回归分析中,吸烟状况(β,1.943;95%置信区间,1.119-3.375,P=0.018)、Tssl-Basal-AL(β,1.002;95%置信区间,1.000-1.004,P=0.043)、中-下间隔节段的收缩期纵向应变峰值时间(Tssl-Mid-IS)(β,1.008;B95%置信区间,1.003-1.013,P=0.004)以及Tssl-Apical-S(β,1.010;95%置信区间,1.004-1.016,P=0.002)在总体人群中仍与较长R-R间期(将中位数849.49毫秒设为临界值)的风险独立相关。我们的研究结果可能为未来左心室收缩同步性及心脏再同步治疗的研究提供依据。