斑点追踪超声心动图评估特发性右束支传导阻滞患者的左右心室变形分析

Evaluation of Right and Left Ventricular Deformation Analysis in İdiopathic Right Bundle Branch Block by Speckle Tracking Echocardiography.

作者信息

Seçkin Göbüt Özden, Sezenöz Burak, Küçükbardaslı Muhammet, Yamak Betül Ayça, Ünlü Serkan

机构信息

Cardiology Department, Gazi University Hospital, Yenimahalle, Ankara, Turkey.

出版信息

Echocardiography. 2025 Feb;42(2):e70056. doi: 10.1111/echo.70056.

DOI:10.1111/echo.70056

PMID:39873330

Abstract

BACKGROUND

Idiopathic right bundle branch block (RBBB) is often seen as harmless and common. However, many studies show it might be linked to negative health outcomes. So, it is crucial to fully understand how RBBB affects the heart's ventricles.

OBJECTIVES

This study aims to examine the right and left ventricular systolic functions in patients with idiopathic RBBB and compare them to those in a healthy control group.

MATERIAL AND METHODS

Echocardiographic images were obtained from patients with idiopathic RBBB and healthy control participants. Conventional echocardiographic parameters were measured. Two-dimensional (2D) speckle tracking strain analysis was used to assess deformation indices.

RESULTS

Thirty-nine patients with idiopathic RBBB and 35 healthy participants were included in the study. There were no significant differences in the chamber dimensions of the left ventricle (LV) and right ventricle (RV) between the groups. LV ejection fraction (EF), RV fractional area change (FAC), and tricuspid annular plane systolic excursion (TAPSE) measurements were similar between the groups. LV global longitudinal strain (GLS) (-25.5 ± 5.7% vs. -22.1 ± 4.2%, p < 0.05), RV GLS (-26.9 ± 4.6% vs. -24.0 ± 4.4%, p < 0.05), and interventricular septum longitudinal strain (IVS LS) (-24.3 ± 4.9% vs. -19.1 ± 4.2%, p < 0.05) were significantly reduced in patients with idiopathic RBBB compared to controls, indicating impaired myocardial shortening. Significant differences were also observed in LV (15 [5-30] vs. 30 [20-60], p < 0.05) and RV (18 [7-35] vs. 36 [24-80], p < 0.05) mechanical dispersion, with the differences being more pronounced for the RV between the groups. LV torsion (2.1 ± 0.6 vs. 1.6 ± 0.5, p < 0.05) was also worse in patients with idiopathic RBBB.

CONCLUSION

Our findings show that idiopathic RBBB significantly affects the longitudinal strain and synchronization of both the LV and RV.

摘要

背景

特发性右束支传导阻滞（RBBB）常被视为无害且常见。然而，许多研究表明它可能与不良健康结果有关。因此，充分了解RBBB如何影响心脏心室至关重要。

目的

本研究旨在检查特发性RBBB患者的右心室和左心室收缩功能，并将其与健康对照组进行比较。

材料与方法

从特发性RBBB患者和健康对照参与者处获取超声心动图图像。测量常规超声心动图参数。使用二维（2D）斑点追踪应变分析来评估变形指数。

结果

本研究纳入了39例特发性RBBB患者和35名健康参与者。两组之间左心室（LV）和右心室（RV）的腔室尺寸无显著差异。两组之间的左心室射血分数（EF）、右心室面积变化分数（FAC）和三尖瓣环平面收缩期位移（TAPSE）测量值相似。与对照组相比，特发性RBBB患者的左心室整体纵向应变（GLS）（-25.5±5.7%对-22.1±4.2%，p<0.05）、右心室GLS（-26.9±4.6%对-24.0±4.4%，p<0.05）和室间隔纵向应变（IVS LS）（-24.3±4.9%对-19.1±4.2%，p<0.05）显著降低，表明心肌缩短受损。在左心室（15[5-30]对30[20-60]，p<0.05）和右心室（18[7-35]对36[24-80]，p<0.05）的机械离散方面也观察到显著差异，两组之间右心室的差异更为明显。特发性RBBB患者的左心室扭转（2.1±0.6对1.6±0.5，p<0.05）也更严重。