Evaluation Of Right Ventricular Synchronization In Patients With Complete Right Bundle Branch Block By Velocity Vector Imaging

Objective Velocity vector imaging technology assessment complete rightbundle branch block right ventricular systolic motion characteristics andsynchronization，and to explore its impact on the structure and function of theright heart.Methods We studied23persons with complete right bundle branch blockwho diagnosed in the General Hospital of Ningxia Medical University，and26healthy volunteers matched with aged and sex. The echocardiographyparameters include：(1) Right atrial length and horizontal diameter、rightventricular length and horizontal diameter、right ventricular and right ventricularoutflow tract anteroposterior diameter、 left ventricular end-diastolic andend-sistolic diameter、 left ventricular ejection fraction.(2) By M-modemeasurements TAPSE，TDI measured tricuspid valve ring right ventricular freewall side of the peak systolic velocity S ’，pulse-doppler measurement tricuspidearly diastolic (E) and late diastolic peak flow vector (A) and E/A radio.(3)VVI measured the basal、middle and apical segments of right ventricular freewall，the basal、middle and apical segments of interventricular septum time topeak myocardial systolic peak velocity and up to75%，50%of the time of peakvelocity，and calculates the maximum difference of segmental wall contractiontime to peak (Tp-diff). Result (1) between CRBBB group and control group comparison：CRBBB group in a length to diameter，right ventricular basal diameter increasethan the control group，the difference was statistically significant (P <0.05)；CRBBB group of tricuspid regurgitation (light-medium)，the incidence of16/23higher than the control group，the difference was statistically significant (P<0.05). The rest of the measurements there was no statistically significantdifference between the two groups；(2) LVEF、TAPSE、TDI-S’ differencesbetween the two groups has no statistical significance；tricuspid valve mouthdiastolic blood flow spectrum，prior to the E/A：(0.79+0.18) CRBBB groupwas obviously less than control group (1.03+0.23)，the difference wasstatistically significant (P <0.01).(3) in addition to the100%Tp groupventricular septal middle segment of the differences between the two groups hasno statistical significance (P>0.05)，the rest of the segment of Tp CRBBBgroup were greater than the control group，difference has statistical significance(P <0.01)；CRBBB group of right ventricular free wall contraction is ventricularseptal significantly delayed，Tp and Tp Tp75and Tp50groups Tp-diff more than100ms.Conclusion (1) VVI can evaluate the complete right bundle branchblock synchronization of myocardial motion.(2) CRBBB patient rightventricular contraction is not synchronized，the right ventricular free wallcontraction than the interventricular septum was significantly delayed.(3)Patients with CRBBB right heart partial reconstruction，right ventricular systolicfunction is normal，diastolic function to reduce.