ABSTRACT
OBJECTIVES@#To compare the left ventricular systolic function between the 1eft bundle branch pacing (LBBP) and right ventricular septum pacing (RVSP) in patients with pacemaker dependence by three-dimensional speckle tracking imaging (3D-STI).@*METHODS@#A total of 65 patients with atrioventricular block (AVB) (Mobitz type II second-degree AVB, high-degree AVB, or third-degree AVB), who underwent permanent cardiac pacing implantation including 32 patients receiving LBBP (LBBP group) and 33 patients receiving RVSP (RVSP group) from June 2018 to June 2019,were enrolled in this study. These patients met the following inclusion criterion: pre-operative left ventricular ejection fraction (LVEF)>50% and ventricular pacing rate>40% at 6-month programming follow-up; and the patients underwent echocardiography at pre-operation and 6 months after operation. The 3D-STI was used to obtain global longitudinal strain (GLS), global circumferential strain (GCS), global radial strain (GRS), and global area strain (GAS).@*RESULTS@#All the patients in the LBBP group and the RVSP group had normal LVEF, there was no significant difference between the 2 group (@*CONCLUSIONS@#For patients with pacemaker dependence and normal LVEF at pre-operation, the cardiac function in the LBBP group is not significantly better than that in the RVSP group in short term follow-up. But in terms of physiologic pacing and long-term cardiac function protection, the 1eft bundle branch pacing is an optimal pacing mode.
Subject(s)
Humans , Bundle of His , Cardiac Pacing, Artificial , Pacemaker, Artificial , Stroke Volume , Ventricular Function, Left , Ventricular Septum/diagnostic imagingABSTRACT
Objective To evaluate left ventricular (LV) systolic function in patients with paroxysmal atrial fibrillation (PAF) after catheter ablation by three-dimensional speckle tracking imaging (3 D-STI). Methods A total of 35 patients with PAF who underwent catheter ablation were enrolled in this study. The participants underwent standard echocardiography and 3 D-STI three to six months before and after the operation. 30 healthy volunteers were enrolled as controls. 3 D-STI was used to obtain global longitudinal strain (GLS) , global circumferential strain (GCS) , global radial strain (GRS) , and global area strain (GAS). Results The LA and E/e' ratio in PAF group showed no significant difference before and after the operation, but were increased compared with controls.There were no significant differences between PAF group and control group in LV, left ventricular end-diastolic volume (LVEDV) , left ventricular end-systolic volume (LVESV) and left ventricular ejection fraction (LVEF) before and after the operation. Compared with control group, GLS and GAS in PAF group were significantly decreased.GAS in PAF group three to six months after catheter ablation was significantly increased. Conclusions Although with normal LVEF, LV systolic function is impaired in patients with PAF. 3 D-STI technique could sensitively reflet the decline in LV myocardial deformation and systolic function.
ABSTRACT
Wave intensity (WI) is a newly proposed hemodynamic index that assesses the working condition of cardiovascular system. The purpose of this study is to investigate the clinical value of WI in assessing the function of cardiovascular system in patients with chronic heart failure (CHF). We used a combined Doppler and echo-tracking system to calculate the carotid artery WI in 16 patients with CHF and 35 normal subjects, and examined the characteristics of WI. The main WI indices included W1, W2, NA, R-W1 and W1-W2. Compared with those in the control group, W1 and W2 were significantly decreased in CHF group (5.44 +/- 3.24 vs. 10.05 +/- 46.33, P < 0.01, 0.83 +/- 0.42 vs. 1.50 +/- 0.95, P < 0.01, respectively), the temporal indices R-W1 shortened (141.06 +/- 41.14 vs. 109.77 +/- 22.50, P < 0.05) and W1-W2 prolonged (214.63 +/- 39.93 vs. 260.51 +/- 20.58, P < 0.01), and the (R-W1)/(W1-W2) ratio was significantly larger in CHF group (0.69 +/- 0.26 vs. 0.43 +/- 0.10, P < 0.01). WI provides a great deal of information about the dynamic behavior of the interaction between the heart and vascular system, so it is a new quantitative approach for analysis of CHF.