Study On Cardiac Systolic Synchronization In Heart Failure Patients With Ischemic Cardiomyopathy

Objective: To evaluate the systolic synchronization of left atrium and ventricle, the left and right ventricles, as well as within the left ventricle with the pulsed wave(PW) and tissue doppler imaging(TDI).Methods : 40 patients with ischemic cardiomyopathy(ICM) were treated as case group, while 25 healthy volunteers without organic heart disease were treated as control group. They were treated with PW to measure the radio of LVFT/RR for evaluating left atrial and left ventricular synchrony, to measure the time difference between the aorta and pulmonary artery pre-ejection period as interventricular mechanical delay(IVMD) for evaluating the synchronization between left and right ventricles, to measure the average peak systolic mitral annular velocity(LV-Sm) and QRS start time to peak systolic velocity(Ts) and the SD of Ts(Ts-SD) of 12 segments from the apical four-chamber, two-chamber, long axis basal and middle segments of each wall for evaluating left ventricular contraction synchrony.Results: The LVFT / RR radio of case and control groups is 41.08±4.65%, 44.74±1.58%(p<0.05), IVMD of case and co ntrol groups is 41.96±4.20 ms and 15.51±5.52 ms(p<0.05), which shows that patients were significantly lower than the control group. LV-Sm were 4.09±1.06 ms, 9.72±0.53 ms, and Ts-SD were 34.13±11.68 ms, 16.47±4.16 ms(p<0.05). In the case group, the Ts of inferior wall(253.40±32.40 ms) and posterior wall(248.40±32.06 ms) is much longer than that of front wall(211.52±36.62 ms) and anterior wall(209.08±34.43 ms). The rates of anteroseptal, after partition, anterior, lateral, posterior, inferior wall including the most delayed systolic part of left ventricular are 8%, 6%, 14%, 12%, 32%, 28%. The Ts of posterior wall(213.16±9.08 ms) in control group is much longer than that of anterior wall and anteroseptal(176.49±10.95 ms) 、(173.94±13.94 ms), p<0.05. The rates of anteroseptal, after partition, anterior, lateral, posterior, inferior wall including the most delayed systolic part of left ventricular are 0%, 17%, 0%, 20%, 37%, 26%, which shows the difference is not statistically significant compared with the case group, p>0.05.Conclusion: Compared with the control group, the left ventricular systolic function of ischemic cardiomyopathy patients is significantly reduced, the systolic synchrony between the left atrium and left ventricle, the left and right chambers, within left ventricle is significantly decreased, and there is difference among the most delayed part in the left ventricle.