Chen Yan, Zhang Yanjuan, Xu Di, Chen Chun, Miao Changqing, Tang Huan, Ge Beibei, Shen Yan, Yao Jing
Department of Cardiology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210029, Jiangsu, People's Republic of China.
Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, Jiangsu, People's Republic of China.
Int J Cardiovasc Imaging. 2022 Jun;38(6):1371-1382. doi: 10.1007/s10554-022-02528-9. Epub 2022 Feb 9.
The study aimed to investigate left ventricular (LV) motion pattern in patients with LBBB patterns including patients with pacemaker rhythm (PM), type B Wolff-Parkinson-White syndrome (B-WPW), premature ventricular complexes originating from the right ventricular outflow tract (RVOT-PVC), and complete left bundle branch block (CLBBB). Two-dimensional speckle tracking was used to evaluate peak value and time to peak value of the LV twist, LV apex rotation, and LV base rotation in patients with PM, B-WPW, RVOT-PVC, and CLBBB with normal LV ejection fraction, and in age-matched control subjects. The LV motion patterns were altered in all patients compared to the control groups. Patients with PM and CLBBB had a similar LV motion pattern with a reduced peak value of LV apex rotation and LV twist. Patients with B-WPW demonstrated the opposite trend in the reduction of LV rotation peak value, which was more dominant in the basal layer. The most impairment in the LV twist/rotation peak value was identified in patients with RVOT-PVC. Compared to the control group, the apical-basal rotation delay was prolonged in patients with CLBBB, followed by those with B-WPW, PM, and RVOT-PVC. The LV motion patterns were different among patients with different patterns of LBBB. CLBBB and PM demonstrated a reduction in LV twist/rotation that was pronounced in the apical layer, B-WPW showed a reduction in the basal layer, and RVOT-PVC in both layers. CLBBB had the most pronounced LV apical-basal rotation dyssynchrony.
本研究旨在调查左束支传导阻滞（LBBB）模式患者的左心室（LV）运动模式，包括起搏器心律（PM）患者、B型预激综合征（B-WPW）患者、起源于右心室流出道的室性早搏（RVOT-PVC）患者以及完全性左束支传导阻滞（CLBBB）患者。采用二维斑点追踪技术评估LV射血分数正常的PM、B-WPW、RVOT-PVC和CLBBB患者以及年龄匹配的对照组受试者的LV扭转峰值、达到LV扭转峰值的时间、LV心尖旋转和LV基底部旋转情况。与对照组相比，所有患者的LV运动模式均发生改变。PM和CLBBB患者的LV运动模式相似，LV心尖旋转和LV扭转峰值降低。B-WPW患者在LV旋转峰值降低方面呈现相反趋势，在基底层更为明显。RVOT-PVC患者的LV扭转/旋转峰值受损最为严重。与对照组相比，CLBBB患者的心尖-基底部旋转延迟延长，其次是B-WPW、PM和RVOT-PVC患者。不同LBBB模式患者的LV运动模式不同。CLBBB和PM表现为LV扭转/旋转降低，在心尖层更为明显，B-WPW表现为基底层降低，RVOT-PVC在两层均降低。CLBBB的LV心尖-基底部旋转不同步最为明显。
