门控核素心肌灌注显像相位分析技术评价束支传导阻滞对左室非同步和心功能的影响
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Evaluation of the impact of bundle branch block on LV dyssynchrony and function using phase analysis of gated myocardial perfusion SPECT imaging
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    摘要:

    目的:应用门控核素心肌灌注SPECT显像(G-MPS)相位分析技术(SyncTool)评价左束支传导阻滞(left bundle branch block,LBBB)和右束支传导阻滞(right bundle branch block,RBBB)对左室非同步及左室功能的影响-方法:连续入选行G-MPS的LBBB-RBBB和正常对照(NL)患者各30例,所有患者的心功能均正常-由Philips Cardio MD QGS自动计算出患者的舒张末期容积(end diastolic volume, EDV)-收缩末期容积(end systolic volume, ESV)和左室射血分数(left ventricular ejection fraction, LVEF);将重建后的G-MPS短轴图像由SyncTool进行室壁相位分析,以得到左室非同步参数相位标准差(phase standard deviation, PSD)和相位直方图带宽(phase histogram bandwidth, PHB)-结果:与RBBB组以及NL组相比,LBBB组的PSD和PHB显著增加(P < 0.01); EDV-ESV显著上升(P < 0.01);LVEF显著下降(P < 0.01)-与NL组相比,RBBB组的上述参数均无统计学差异(P < 0.01)-若以PSD > 12.4°作为判断左室非同步的标准,则LBBB组-RBBB组和NL组的左室非同步发生率分别为70.0%-16.7%-0.0%;若以PHB > 43.7°作为判断左室非同步的标准,则LBBB组-RBBB组和NL组的左室非同步发生率分别为63.3%-13.3%-3.3%-PSD(或PHB)异常的LBBB亚组的左室功能明显低于PSD(或PHB)正常亚组(P < 0.01)-结论:G-MPS相位分析技术能够准确评价束支传导阻滞对左室非同步的影响,LBBB更易引起明显的左室非同步及心功能下降-

    Abstract:

    Objective:To evaluate the impact of left or right bundle branch block(LBBB or RBBB) on LV dyssynchrony and function using phase analysis of gated myocardial perfusion SPECT. Methods: Thirty patients with LBBB, thirty with RBBB and thirty normal subjects with normal cardiac function were enrolled in this study. They all underwent gated myocardial perfusion SPECT imaging. End diastolic volume (EDV), end systolic volume (ESV) and LV ejection fraction (LVEF) were calculated from Philips Cardio MD QGS; The reconstructed data were then submitted to SyncTool to measure phase standard deviation(PSD), phase histogram bandwidth(PHB). Results: All parameters studied showed statistically significant differences between the LBBB and RBBB or control groups. There are no statistically differences between RBBB and control groups. Normal values were calculated based on control group. If PSD > 12.4° is considered dyssynchrony, the rate of LV dyssynchrony in LBBB, RBBB and NL groups is 70%, 16.7%, 0.0%, respectively. If PHB > 43.7° is considered dyssynchrony, the rate of LV dyssynchrony in LBBB, RBBB and NL groups is 63.3%, 13.3%, 3.3%, respectively. Conclusion: Phase analysis of G-MPS can effectively evaluate the LV dyssynchrony caused by LBBB accurately. LBBB can lead to obvious LV dyssynchrony and dysfunction.

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潘春奇,李殿富,周艳丽,冯建林,袁冬兰,赵中强,曹克将,陈 季.门控核素心肌灌注显像相位分析技术评价束支传导阻滞对左室非同步和心功能的影响[J].南京医科大学学报(自然科学版),2011,(6):851-855

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  • 收稿日期:2010-12-15
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