Evaluation of left and right atrial synchrony in patients with sick sinus syndrome before and after pacemaker implantation by tissue Doppler ultrasonography
10.3760/cma.j.issn.1004-4477.2017.12.001
- VernacularTitle:组织多普勒超声评价病窦综合征患者起搏器置入前后左右心房的同步性
- Author:
Xue FENG
1
;
Min LU
;
Maohui ZHANG
;
Jianli REN
;
Haitao RAN
;
Zhigang WANG
Author Information
1. 400010,重庆医科大学超声影像研究所
- Keywords:
Echocardiography;
Sick sinus syndrome;
Atrial function;
Cardiac pacing,artificial
- From:Chinese Journal of Ultrasonography
2017;26(12):1013-1017
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the intra- and interatrial synchronization before and after pacemaker implantation in patients with sick sinus syndrome ( SSS) by tissue Doppler imaging ( TDI) . Methods Thirty-eight patients with SSS ( SSS group ) underwent pacemaker implantation . Echocardiography was performed before and after operation . Twenty-five volunteers were chosen as control group . Routine measurement of left and right atrial diameter by echocardiography . In apical four chamber view ,the sample volume of TDI was located at right atrial lateral wall at tricuspid annulus ,interatrial septum and left atrial lateral wall at mitral annulus . The interval time between the early diastolic wave ( E wave) and the late diastolic wave (A wave) (E-AR ,E-AI ,E-AL ) ,and the duration of A wave (AR ,AI ,AL ) were measured . At the same time ,the electromechanical coupling time was measured ,namely the initiation of the P wave of the synchronous electrocardiogram to the starting point of A wave ( P-A0R ,P-A0I ,P-A0L ) , and the starting point of the P wave to the peak point of the A wave ( P-AR ,P-AI ,P-AL ) . And the right atrial electromechanical delay time ,P-A0I and P-A0R value ( T0IR ) ,P-AI value and P-AR value ( TIR ) were recorded .Other parameters include left atrial electromechanical delay time:P-A0L and P-A0I value ( T0LI ) , and P-AL and P-AI value ( TLI ) ;interatrial electromechanical delay time:P-A0L and P-A0R value ( T0LR ) ,P-AL and P-AR ( TLR ) were recorded . Results Compared with the control group ,left atrium and right atrium in SSS group enlarged before operation , E-AR ,E-AI ,E-AL ,P-A0R ,P-A0I ,P-AR ,P-AL prolonged ,while T0LR and T0LI were shortened ( all P < 0 .05 ) . Postoperative changes in SSS group patients included shortened E-AR ,E-AI and E-AL ,and prolonged T0LI and T0LR ( all P <0 .05) . Compared with the control group ,the size of left atriums and right atriums in SSS group still increased postoperation ,and the P-A0I 、P-AR and P-AL remained longer (all P <0 .05) . The same as the control group ,the postoperative AR ,AI and AL in SSS group were decreased successively ( all P < 0 .05 ) . Conclusions In SSS patients , electromechanical asynchrony exists in different part of atrium and between left atrium and right atrium . Pacemaker therapy can improve atrial electromechanical synchronicity .
