Home    中文  
 
  • Search
  • lucene Search
  • Citation
  • Fig/Tab
  • Adv Search
Just Accepted  |  Current Issue  |  Archive  |  Featured Articles  |  Most Read  |  Most Download  |  Most Cited

Chinese Journal of Medical Ultrasound (Electronic Edition) ›› 2023, Vol. 20 ›› Issue (12): 1223-1230. doi: 10.3877/cma.j.issn.1672-6448.2023.12.001

• Cardiovascular Ultrasound •    

Evaluation of left ventricular myocardial synchrony under different pacing modes by speckle tracking imaging and tissue Doppler synchronous imaging

Qingguo Meng1, Yijia Tang2, Sijia Wang1, Jie Zhou2, Tianhang Feng3, Xuebing Liu1, Qinglan Shu1, Yan Deng1, Lixue Yin1,(), Chunmei Li1   

  1. 1. Department of Cardiovascular Ultrasound and Non-invasive Cardiology, Ultrasound in Cardiac Electrophysiology and Biomechanics Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, National Center for Clinical Medical Research of Cardiovascular Diseases, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu 610072, China
    2. Department of Cardiology, Ultrasound in Cardiac Electrophysiology and Biomechanics Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, National Center for Clinical Medical Research of Cardiovascular Diseases, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu 610072, China
    3. Department of Anesthesiology, Ultrasound in Cardiac Electrophysiology and Biomechanics Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, National Center for Clinical Medical Research of Cardiovascular Diseases, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu 610072, China
  • Received:2022-10-17 Online:2023-12-01 Published:2024-03-05
  • Contact: Lixue Yin

Abstract:

Objective

To investigate the advantages and disadvantages of left ventricular synchrony in patients with right ventricular double-chamber septal pacing (RVSP) and His-Purkinje system pacing (HPSP) using two-dimensional speckle tracking imaging and tissue synchrony imaging (TSI) techniques.

Methods

Forty-three patients who underwent atrioventricular universal pacemaker implantation at Sichuan Provincial People's Hospital from February 2020 to September 2021 were prospectively divided into an RVSP group (n=20) and an HPSP group (n=23). In the same period, 40 volunteers were selected as a control group. The dynamic two-dimensional grayscale and TSI images of the standard apical tri-plane section of each group were collected for three consecutive cardiac cycles, and the time to peak strain, peak strain dispersion (PSD), and the work of each segment of the left ventricle in the same cardiac cycle were obtained offline. The above parameters were analyzed and compared by taking the average of three cardiac cycles.

Results

With regard to TSI pattern, compared with the control group, the time to peak strain of 12 (12 /12) segments in both the HPSP group and RVSP group were increased (P<0.05 for all). There was a significant difference in the time to peak strain of 4 (4/12) segments between the HPSP group and RVSP group: The time to peak strain of the anterior basal wall, anterior septum of middle segment, middle septum, and posterior wall of middle segment in the RVSP group was longer than that in the HPSP group (P<0.05 for all). Two-dimensional speckle tracking imaging showed that compared with the control group, the time to peak strain of 13 segments in the HPSP group and/or RVSP group was increased (P<0.05). There was a significant difference in the time to peak strain of 11 (11/17) segments between the HPSP group and RVSP group, and the time to peak strain of 7 segments in the HPSP group was longer than that in the RVSP group (P<0.05 for all). Compared with the control group, the long-axis strain of the left ventricle and the overall myocardial work efficiency of the left ventricle decreased significantly in the RVSP group (P<0.05 for both), but there was no significant difference between the HPSP group and the normal control group (P>0.05 for both). PSD increased gradually and sequentially in the control group, HPSP group, and RVSP group (P<0.05).

Conclusion

During the short-term follow-up from 6 months to 1 year after pacemaker implantation, HPSP can make the left ventricular myocardium more coordinated and efficient, and the left ventricular synchronization is better than that with RVSP. Compared with TSI, two-dimensional speckle tracking technique can also simultaneously evaluate myocardial synchronization parameters of each segment of the left ventricular apex without angle dependence, which provides more comprehensive information for clinicians, suggesting that this technique has more advantages in evaluating synchronization.

Key words: Echocardiography, Speckle tracking imaging, Tissue synchrony imaging, His-Purkinje system pacing, Right ventricular septal pacing, Myocardial function

Copyright © Chinese Journal of Medical Ultrasound (Electronic Edition), All Rights Reserved.
Tel: 010-51322630、2632、2628 Fax: 010-51322630 E-mail: csbjb@cma.org.cn
Powered by Beijing Magtech Co. Ltd