To investigate changes of intraatrial and interatrial electromechanical contraction function in coronary artery disease (CAD) patients with metabolic syndrome (MS) using pulsed wave Doppler tissue imaging (PW-TDI) and synchronous electrocardiagram (ECG). Methods Totally 139 consecutive CAD patients were divided into CAD with MS (CAD-MS group, n= 66) and CAD without MS group (CAD-NMS group, n = 73). The time intervals of electromechanical contraction between onset of P wave and onset of A wave in atrial myocardium were measured with PW-TDI and synchronous ECG. Meanwhile, the peak A wave velocity of atrial wall movement was compared. Results The time interval of atrial electromechanical contraction between onset of P wave and onset of A wave in CAD-MS group was significantly longer than that in CAD-NMS group (P<0. 05). The movement velocity of left atrial anterior wall in CAD-MS group was lower than that in CAD-NMS group ([6. 12±2. 27]cm/s vs [7. 00±2. ll]cm/s, P<0.05) , and the electromechanical contraction time interval of left atrial anterior wall in CAD-MS group was significantly delayed compared with that in CAD-NMS group (F<0. 05). The electromechanical contraction time difference between left atrial anterior wall and inferior wall atrium in CAD-MS group was statistically different (P<0. 05). Conclusion Intraatrial and interatrial mechanical contraction time is significantly delayed and mechanical desynchrony exists in part of left atrium in CAD with MS patients.%目的 应用脉冲组织多普勒技术(PW-TDI)和同步ECG观察冠心病合并代谢综合征患者心房内和心房间的电-机械收缩同步性的变化.方法 将139例冠心病患者分为冠心病合并代谢综合征组(CAD-MS组,n=66)和冠心病不合并代谢综合征组(CAD-NMS组,n=73).对ECG P波起始点到PW-TDI心房收缩A峰起始点的时间间期进行统计分析,比较两组间心房壁收缩速度和心房各壁的电-机械收缩时间的变化.结果 与CAD-NMS组相比,CAD-MS组中左右心房各壁心电图P波起始点到PW-TDI心房收缩A峰起始点的时间间期明显延长(P＜0.05),左心房前壁运动速度降低[(6.1 2士2.27)cm/s vs(7.00±2.11)cm/s,P＜0.05],左心房前壁心电图P波起始点到PW-TDI心房收缩A峰起始点时间间期较其他房壁明显延长(P＜0.05),左心房前壁与下壁心电图P波起始点到PW-TDI心房收缩A峰起始点电-机械收缩时间差值明显增大(P＜0.05).结论 冠心病合并代谢综合征患者心房内和心房间的电-机械收缩时间出现延迟,左心房部分房壁存在电-机械传导不同步.
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