Deep insight into cardiac dysfunction in children and young adults with Wolff-Parkinson-White syndrome using speckle tracking imaging
Deep insight into cardiac dysfunction in children and young adults with Wolff-Parkinson-White syndrome using speckle tracking imaging
复制标题
使用散斑跟踪成像深入了解患有沃尔夫-帕金森-怀特综合征的儿童和年轻人的心脏功能障碍
DOI：
10.1007/s00380-021-01848-5
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发表时间：
2021
影响因子：
1.5
通讯作者：
Shimizu Toshiaki
中科院分区：
文献类型：
--
作者：
Akimoto Satoshi;Fukunaga Hideo;Akiya Azusa;Hosono Yu;Iso Takeshi;Shigemitsu Sachie;Tanaka Noboru;Tabuchi Haruna;Hayashi Hidemori;Sekita Gaku;Takahashi Ken;Shimizu Toshiaki
虽然通过旁道（AP）的心室预激可导致患有预激综合征（WPW）的儿童和年轻人的心功能不全，但潜在的心功能不全机制尚不清楚。本研究旨在通过层特异性应变分析来描述心功能不全的特征，并阐明根据AP位置分类的WPW综合征患者的敏感心功能不全指标。24例平均年龄14.1岁（6.9-21.6岁）的WPW综合征患者（11例：A型伴左侧AP [WA组]，13例：B型伴右侧AP [WB组]）和37例年龄匹配的正常对照（N组）进行了检查。我们测量了左心室（LV），基底，中间和顶部水平的圆周应变（CS），和纵向应变（LS）使用层特异性应变斑点跟踪成像。不同步性也是根据每个节段的径向应变的时间来测量的。与N组相比，WA组和WB组的CS的峰值肌内膜基质和中间水平均较低。与N组相比，仅WB组中CS的峰值心肌中层和心肌外膜基础水平以及CS的峰值心肌中层水平较低。与N组相比，所有三个层中的峰值LS仅在WB组中较低。仅在基线水平，患者组和正常组的不同步指数有显著差异，而各组之间的左室射血分数（EF）无显著差异。尽管EF值正常，但WB组中更多部位的层特异性应变降低。层特异性菌株是检测心功能不全早期阶段的敏感指标。
Although ventricular pre-excitation via accessory pathways (APs) causes cardiac dysfunction in children and young adults with Wolff–Parkinson–White (WPW) syndrome, the underlying cardiac dysfunction mechanisms are unclear. This study aimed to characterize cardiac dysfunction and clarify sensitive cardiac dysfunction indicators in WPW syndrome patients classified by the APs location with a layer-specific strain analysis. Twenty-four patients with WPW syndrome with a mean age of 14.1 years (6.9–21.6 years) (11 cases: type A with a left-sided AP [WA group], 13 cases: type B with a right-sided AP [WB group]), and 37 age-matched normal controls (N group) were examined. We measured the left ventricle (LV), base-, mid-, and apical-level of circumferential strain (CS), and longitudinal strain (LS) using a layer-specific strain with speckle tracking imaging. Dyssynchrony was also measured based on the timing of the radial strain at each segment. Peak endomyocardial base- and mid-level of CS was lower in both the WA and WB groups compared to the N group. Peak mid-myocardial and epimyocardial base-level of CS and peak mid-myocardial mid-level of CS were lower only in the WB group compared to the N group. Peak LS in all three layers was lower only in the WB group compared to the N group. There was a significant difference between the patient and normal groups for the dyssynchrony index only at the base-level, and there was no significant difference between the groups for LV ejection fraction (EF). Layer-specific strain decreased in more sites in the WB group despite the normal EF value. Layer-specific strains are sensitive indicators for the detection of the early stages of cardiac dysfunction.