CAJ | 학술논문

目的：探讨射频消融术（RFCA）治疗心动过速型心肌病（TCM）后左室收缩功能的恢复情况。方法：收集2010年7月至2013年7月在我院因心律失常行消融治疗患者共715例，其中33例左室射血分数（LVEF）＜50％，且术后升高≥15％的心动过速型心肌病患者纳入研究。经消融治疗1周后，早期LVEF改善明显的（与基线相比，术后第1周LVEF升高幅度≥25％）设为改善组，无明显变化的则为未改善组。所有患者术后1周、3个月、6个月、12个月均行超声心动图检查。结果：患者基线左室舒张末期内径及LVEF分别为（55±10．7）mm，（38±4．6）％。早期LVEF明显改善者16例，经过12个月的随访，改善组与未改善组相比，保持较高的LVEF[（69．2±4．2）％vs （58．1±6．9）％， P＜0．001]。结论：RFCA被证明是一种较为安全而有效的治疗方法；房颤相关的TCM节律控制优于室率控制；术后早期 LVEF的改变对患者左室功能的恢复具有预测作用。
목적：탐토사빈소융술（RFCA）치료심동과속형심기병（TCM）후좌실수축공능적회복정황。방법：수집2010년7월지2013년7월재아원인심률실상행소융치료환자공715례，기중33례좌실사혈분수（LVEF）＜50％，차술후승고≥15％적심동과속형심기병환자납입연구。경소융치료1주후，조기LVEF개선명현적（여기선상비，술후제1주LVEF승고폭도≥25％）설위개선조，무명현변화적칙위미개선조。소유환자술후1주、3개월、6개월、12개월균행초성심동도검사。결과：환자기선좌실서장말기내경급LVEF분별위（55±10．7）mm，（38±4．6）％。조기LVEF명현개선자16례，경과12개월적수방，개선조여미개선조상비，보지교고적LVEF[（69．2±4．2）％vs （58．1±6．9）％， P＜0．001]。결론：RFCA피증명시일충교위안전이유효적치료방법；방전상관적TCM절률공제우우실솔공제；술후조기 LVEF적개변대환자좌실공능적회복구유예측작용。
Objective To determine the baseline echocardiographic characteristics and the time course and degree of recovery of left ventricular (LV) systolic dysfunction in patients with tachycardia-induced cardiomyopathy ( TCM ) . Methods Seven hundred and fifteen patients received radiofrequency cather ablation ( RFCA ) for tachycardiarrhymias from July 2010 to July 2013 were screened in this study. Only 33 patients with reduced left ventricular ejection fraction (LVEF) (LVEF<50% and improved≥15%) were diagnosed with tachycardia-induced cardiomyopathy and were included in the study. Patients with early improvement (over 25%increase in LVEF at 1-week follow-up compared to the baseline ) were enrolled in the improved group , and the rest patients were enrolled in the improved group. All Patients received transthoracic echocardiography for LV size and function detection at 1 week and at 3,6,12 months follow-up. Results The average baseline of the LV end-diastolic diameter, and the LVEF were (55 ± 10.7)mm and (38 ± 4.6)%, repectively. Early improvement ( over 25%increase in LVEF at 1-week follow-up compared to the baseline ) in the improved group was observed in 16 patients. Patients with early improvement had higher LVEF at 12-month follow-up compared to the patients without early improvement [(69.2± 4.2)% vs (58.1 ± 6.9)%, P < 0.001]. Conclusions RFCA is proved to be a relatively safe and effecient treatment method. Atrial fibrillation related to TCM , rhythm control is superior to the rate control. The early improvement in LVEF may potentially predict the complete reversibility of LV systolic dysfunction.