Department of Cardiovascular Ultrasound, First Hospital of China Medical University.
Department of Cardiology, Mayo Clinic.
Circ J. 2018 Jul 25;82(8):2111-2118. doi: 10.1253/circj.CJ-17-1422. Epub 2018 Jun 21.
Septal leftward motion followed by a counter motion during early systole is known as septal flash (SF) in patients with isolated complete left bundle-branch block (cLBBB). This study aimed to determine the predictive value of SF for reduction of left ventricular (LV) global systolic function using 2D speckle-tracking echocardiography (2D STE) in cLBBB patients.
The study group of 41 patients with isolated cLBBB and preserved LV ejection fraction and 41 age- and sex-matched control subjects were studied. The presence of SF and LV global longitudinal strain (GLS) were defined and measured using 2D STE. Multivariate logistic regression analysis identified the presence of SF as an independent factor predicting LV GLS >-20% in isolated cLBBB patients (odds ratio, 1.38; 95% confidence interval, 1.10-1.72; P=0.005). LV GLS in cLBBB patients with SF further decreased over time, whereas LV GLS did not decrease in patients without SF. The presence of SF was shown to be an independent factor predicting the reduction of LV global systolic function (relative reduction in LV GLS >15% from baseline to 2-year follow-up) (odds ratio, 1.27; 95% confidence interval, 1.06-1.50; P=0.008).
Assessment of SF by 2D STE may be an easy and effective method of predicting the reduction in LV global systolic function in isolated cLBBB patients.
在孤立性完全左束支传导阻滞（cLBBB）患者中，收缩早期间隔向左运动随后反向运动被称为间隔闪烁（SF）。本研究旨在使用二维斑点追踪超声心动图（2D STE）确定 SF 对 cLBBB 患者左心室（LV）整体收缩功能降低的预测价值。
本研究纳入了 41 例孤立性 cLBBB 且 LV 射血分数正常的患者和 41 名年龄和性别匹配的对照组。使用 2D STE 定义和测量 SF 的存在和 LV 整体纵向应变（GLS）。多变量逻辑回归分析确定 SF 的存在是预测孤立性 cLBBB 患者 LV GLS＞-20%的独立因素（比值比，1.38；95%置信区间，1.10-1.72；P=0.005）。SF 存在的 cLBBB 患者的 LV GLS 随时间进一步降低，而无 SF 的患者的 LV GLS 没有降低。SF 的存在是预测 LV 整体收缩功能降低的独立因素（与基线相比，LV GLS 相对降低＞15%，随访 2 年）（比值比，1.27；95%置信区间，1.06-1.50；P=0.008）。
2D STE 评估 SF 可能是预测孤立性 cLBBB 患者 LV 整体收缩功能降低的一种简单有效的方法。
