YANG Licui,WANG Kaihua,HUANG Xumei, et al. Ultrasound study of ventricular synchronicity in patients with ischemic cardiomyopathy accompanied with complete left bundle branch block[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2014, 44(11): 800-803.
Abstract：Objective: To identify the difference of left ventricular and interventricular synchronicity found on echocardiogram between patients with ischemic cardiomyopathy (ICM) accompanied with complete left bundle branch block (CLBBB) and those with isolated left bundle branch block. Methods: Thirty-two patients with ICM accompanied with CLBBB (the study group) and 30 patients with isolated left bundle branch block (the control group) were enrolled. The standard deviation of systolic peak time (Ts-SD) in 12 segments along the long axis of left ventricular motion, including the left ventricular septal, the lateral wall, the anterior wall, the inferior wall, the posterior wall of basal segment and the middle segment were evaluated by quantitative tissue velocity imaging (QTVI). The septal-to-posterior wall motion delay (SPWMD) in parasternal long axis was assessed by M-mode echocardiogram. The interventricular mechanical delay (IVMD) of left and right ventricle was measured by pulse Doppler. Results: Compared with the control group, Ts-SD, SPWMD and IVMD in the study group were increased significantly (P<0.001). The results of linear correlation analysis indicated that the left ventricular and interventricular synchronicity was positively correlated with the size of ventricle, the width of QRS wave and N terminal pro brain natriuretic peptide (NT-proBNP). Conclusion: Patients with ICM accompanied with CLBBB have obvious left ventricular and interventricular dyssynchrony. Echocardiogram is valuable in the assessment of ventricular dyssynchrony.
[1]Yu CM, Chau E, Sanderson JE, et al. Tissue Doppler echo-cardiographic evidence of reverse remodeling and improved synchronicity by simultaneously delaying regional contraction after biventricular pacing therapy in heart failure[J]. Circulation, 2002, 105(4): 438-445.
[2]Miller WL, Ballman KV, Hodge DO, et al. Risk factor implicat ions of incidentally discovered uncomplicated bundle branch block[J]. Mayo Clin Proc, 2005, 80(12): 1585-1590.
[3]Ozdemir K, Altunkeser BB, Danis G, et al. Effect of the isolated left bundle branch block on systolic and diastolic functions of left ventricle[J]. J Am Soc Echocardiography,2001, 14(11): 1075-1079.
[4]刘书丽, 马秀丽, 王燕霞. 利用实时三维超声心动图对完全性左束支传导阻滞患者左心室运动同步性的评价[J].中国超声医学杂志, 2013, 29(4): 328-331.
[5]李治安, 张烨. 超声评价心脏机械同步性的方法及进展[J].心血管病学进展, 2007, 28(6): 840-844.
[6]Prinzen FW, Peschar M. Relation between the pacing induced sequence of activation and left ventricular pump function in animals[J]. Pacing Clin Electrophysiol, 2002, 25 (4 Pt 1): 484-498.
[7]金辰, 陈俊, 高立建, 等. 完全性左束支传导阻滞733例临床分析[J]. 中华老年多器官疾病杂志, 2010, 9(1): 44-47.
[8]Das MK, CherpararIlbiI K, Bedi A, et al. Prolonged QRS duration (QRS 170 ms) and left axis deviation in the presence of left bundle branch block: a marker of poor left ventricular systolic function[J]. Am Heart J, 2001, 142(5): 756-764.
