摘要目的 分析B型预激综合征(type B Wolff-Parkinson-White syndrome,B-WPW)患者左心室扭转参数,探讨B-WPW患者左心室运动模式的改变.方法 选取B-WPW患者38例,志愿者40例作为对照组,应用二维斑点追踪成像技术(two-dimensional speckle tracking imaging,2D-STI)测量B-WPW患者射频消融术前(B-WPW-B组)、术后(B-WPW-A组)以及对照组左心室扭转参数,包括左心室扭转角度峰值、左心室心底部及心尖部旋转角度峰值及达峰时间,计算左心室心底部与心尖部旋转角度达峰时间差值(RDA-B);采用双平面Simpson法测量各组左心室舒张末期容积(LVEDV)、收缩末期容积(LVESV)及左心室射血分数(LVEF).同步测量心电图Ⅱ导联QRS波时限,并将上述各项参数分别与RDA-B及QRS波时限进行相关性分析.结果 与对照组比较,B-WPW患者左心室扭转角度峰值及左心室心尖部、心底部旋转角度峰值下降(心底部较心尖部明显)(P＜0.05);心底部旋转角度提前达峰(P=0.004),与对照组相比,心底-心尖部旋转角度达峰时间不同步(P=0.002);左心室心腔扩大,QRS波时限延长(P=).000);射频消融术后B-WPW患者左心室扭转参数恢复(P＜0.05),但仍低于对照组(P＜0.05).结论 B-WPW患者左心室运动模式发生变化,表现为扭转角度峰值及时序的改变,左心室心底-心尖旋转的失同步;射频消融术后近期患者运动模式改善,但未恢复至正常水平.

abstractsObjective To investigate the left ventricular (LV) torsion parameters of type B WolffParkinson-White syndrome (B-WPW) and to explore alternation of the left ventricular motion pattern in patients with B-WPW.Methods Thirty-eight patients with B-WPW were studied.And 40 volunteers were selected as control.Two-dimensional speckle tracking imaging (2D-STI) was used to acquire left ventricular torsion parameters,including peak value and time to peak value of LV twist,LV apex rotation,and LV base rotation.Apical-basal rotation delay (RDA-B) was calculated.Biplane Simpson method was used to measure LV end-diastolic volume (LVEDV),end-systolic volume (LVESV) and ejection fraction (LVEF).All above parameters were measured in patients with B-WPW before (B-WPW-B group) and after (B-WPW-A group) radiofrequency catheter ablation and in control group.The QRS width of lead Ⅱ was recorded,and the relationships between all above parameters with the RDA-B or QRS width were analyzed.Results Compared with the contrd group,in patients with B-WPW,the peak value of LV apex rotation (RotA),LV base rotation (RotB) and LV twist (TwistLV) were lower(LV base was more obvious than LV apex)(P ＜0.05),the time to RotB (TTPB) was shorter (P =0.004),RDAB was longer(P =0.002),the left ventricular enlarged and the QRS prolonged (P =0.000).After radiofrequency catheter ablation,the left ventricular torsion parameters in patients with B-WPW recovered significantly(P ＜0.05),but still lower than those in the control group(P ＜0.05).Conclusions The left ventricular motion pattern of patients with B-WPW alters,including the changes of peak value and time to peak value in LV apex rotation,LV base rotation and LV twist,as well as LV myocardium dyssynchrony.The motion pattern of LV in patients with B-WPW is improved in acute stage after radiofrequency catheter ablation but not yet recover totally.