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目的探讨组织多普勒超声心动图评估不同起搏模式对左心室收缩同步性及心功能的价值。方法 15例植入双腔起搏器的患者,分别以AAI、DDD和VVI模式起搏5min和3个月后行彩色和组织多普勒检查,测量左心室射血分数(LVEF)、每搏输出量(SV)、12节段收缩速度达峰时间标准差(TS-SD)、收缩峰速度平均值(Vs-m)、舒张早期速度达峰时间标准差(TD-SD)、舒张早期峰值速度(E)、舒张晚期峰值速度(A)、舒张早期峰值速度(Em)、舒张晚期峰值速度(Am),并计算E/A、Em/Am和E/Em。结果在5min和3个月时AAI的TS-SD与TD-SD明显小于DDD和VVI(P<0.05)。三种起搏模式TS-m和E/A在5min和3个月均无明显差异(P>0.05)。DDD和VVI起搏5min后LVEF、Em/Am、E/Em与AAI相比无明显差异(P>0.05),但VVI模式SV明显低于AAI及DDD(P<0.05)。随访3个月LVEF在AAI、DDD和VVI分别为(70.90±12.99)%、(65.75±6.49)%和(60.25±7.13)%(P<0.05);舒张功能随访3个月时有差异,AAI优于DDD及VVI(P<0.05)。结论组织多普勒成像可以客观准确地评估永久起搏患者心室收缩同步性及心功能。
Objective To investigate the value of tissue Doppler echocardiography in assessing systolic left ventricular systolic and cardiac function in different pacing modes. Methods Fifteen patients with double-chamber pacemaker were examined by color Doppler and tissue Doppler imaging after 5 min and 3 months of pacing in AAI, DDD and VVI modes respectively. Left ventricular ejection fraction (LVEF), stroke volume (SV), peak systolic velocity (TS-SD), systolic peak velocity (Vs-m), standard deviation of peak diastolic velocity (TD-SD), peak early diastole (E), peak late diastolic velocity (A), early diastolic peak velocity (Em) and peak diastolic velocity (Am) were calculated and E / A, Em / Am and E / Em were calculated. Results At 5 and 3 months, the TS-SD and TD-SD of AAI were significantly lower than those of DDD and VVI (P <0.05). There was no significant difference in TS-m and E / A between the three pacing modes at 5 and 3 months (P> 0.05). There were no significant differences in LVEF, Em / Am, E / Em and AAI between DDD and VVI after 5 min of pacing (P> 0.05), but SV of VVI mode was significantly lower than that of AAI and DDD (P <0.05). The 3-month follow-up of LVEF was (70.90 ± 12.99)%, (65.75 ± 6.49)% and (60.25 ± 7.13)% in AAI, DDD and VVI, respectively Better than DDD and VVI (P <0.05). Conclusion Tissue Doppler imaging can objectively and accurately evaluate the systolic and cardiac function of patients with permanent pacing.