目的研究速度向量成像技术(VVI)在指导心脏再同步化治疗(CRT)患者的筛选、左室电极的植入及评价CRT疗效的临床应用价值。方法药物难治性心力衰竭患者17例,年龄60±13岁,NYHA心功能分级Ⅲ或Ⅳ级,术前均经VVI评价左室内十二节段任2个节段收缩达峰时间的最大差值及标准差,并分析左室内收缩最延迟部位。行CRT治疗,将左室电极植入左心收缩最延迟部位相关的冠状静脉窦分支血管内。分别在术后第1,3个月进行随访。观察CRT治疗后患者心功能分级、超声心动图测定心功能指标,以及VVI评价同步性参数的变化。结果随访3个月,患者心功能分级提高I～II级,6min步行距离由309.77±76.05m增至402.06±87.09m(P<0.05),左室射血分数由0.32±0.04增加至0.42±0.07(P<0.01),二尖瓣返流减少。VVI结果显示室内不同步较术前有明显改善。结论VVI技术可用于评价心脏的同步化状态、指导CRT的治疗及评价疗效。 Objective To investigate the clinical value of velocity vector imaging (VVI) in guiding the screening of patients with cardiac resynchronization therapy (CRT), the implantation of left ventricular electrodes and evaluating the curative effect of CRT. Methods Seventeen patients with refractory heart failure, aged 60 ± 13 years and NYHA functional class Ⅲ or Ⅳ, were evaluated by VVI preoperatively to determine the maximum difference between the peak systolic diameters of any two segments of the left ventricular segment Value and standard deviation, and analysis of the most delayed left ventricular contraction site. CRT treatment, the left ventricular electrode implantation in the most delayed part of the left ventricular systolic coronary branch of the blood vessels. Follow-up was performed in the first and third months after operation. To observe the classification of cardiac function in patients after CRT treatment, echocardiographic measurement of cardiac function, and VVI evaluation of synchronization parameters. Results The follow-up period was 3 months. The patients’ heart function grading increased from grade I to II. The walking distance increased from 309.77 ± 76.05m to 402.06 ± 87.09m (P <0.05) at 6min, and the left ventricular ejection fraction increased from 0.32 ± 0.04 to 0.42 ± 0.07 (P <0.01), mitral regurgitation decreased. VVI results show that there is a significant improvement in indoors asynchrony compared with that before operation. Conclusion VVI technique can be used to evaluate the cardiac synchronization status, guide the treatment of CRT and evaluate the curative effect.