CAJ | 학술논문

目的：探讨病态窦房结综合征（SSS）患者右室流出道间隔部（RVOTs）和右室心尖部（RVA）起搏对心功能的影响。方法：选取62例确诊为SSS 的患者，术前随机分为AAI组、RVOTs组和RVA 组，均植入DDD/DDDR起搏器。术后1个月、6个月、1年随访，使用组织多普勒测定Tei指数、E/E ’，同时测定传统超声参数，比较其差异。结果：术后1年， LV Tei和RV Tei指数在AAI组数值最小，RVOTs组其次，RVA组最高；E/E’在RVA 组数值最高，AAI 组最低，差异有统计学意义（P＜0．05）；术后1年，LVEF 在 AAI 组最高， RVA组最低，差异有统计学意义（P＜0．05）。术后1年，SV在AAI组数值最高，RVA组最低，差异有统计学意义（P＜0．05）。结论：SSS患者RVOTs起搏比RVA起搏可获得更好的心功能及血流动力学效应，但仍不如AAI起搏。
목적：탐토병태두방결종합정（SSS）환자우실류출도간격부（RVOTs）화우실심첨부（RVA）기박대심공능적영향。방법：선취62례학진위SSS 적환자，술전수궤분위AAI조、RVOTs조화RVA 조，균식입DDD/DDDR기박기。술후1개월、6개월、1년수방，사용조직다보륵측정Tei지수、E/E ’，동시측정전통초성삼수，비교기차이。결과：술후1년， LV Tei화RV Tei지수재AAI조수치최소，RVOTs조기차，RVA조최고；E/E’재RVA 조수치최고，AAI 조최저，차이유통계학의의（P＜0．05）；술후1년，LVEF 재 AAI 조최고， RVA조최저，차이유통계학의의（P＜0．05）。술후1년，SV재AAI조수치최고，RVA조최저，차이유통계학의의（P＜0．05）。결론：SSS환자RVOTs기박비RVA기박가획득경호적심공능급혈류동역학효응，단잉불여AAI기박。
Objective To evaluate the effect of pacing in right ventricular outflow septal (RVOTs) or in right ventricular apex (RVA) on cardiac function in patients with sick sinus syndrome. Methods Sixty-two patients with sick sinus syndrome (SSS) were enrolled into the study. They were divided into AAI, RVOTs and RVA groups and implanted DDD/DDDR pacemakers in different pacing sites. The follow-up was ranged from 1 to 12 months after operation. Then we measured Tei index , E/E′and other parameters. And their difference in cardiac function and hemodynamic effect among different groups were compared. Results At 1 year post-operation there were significant differences in Tei index and E/E' among 3 groups (P < 0.05). LV and RV Tei index of RVOTs group was higher than that of AAI group , and LV and RV Tei indexes of RVA group were the highest among the three groups. E/E'of RVA group was the highest and in AAI group was the lowest. At 1 year post-operation LVEF and SV of AAI group were the highest, and those in RVA group were the lowest. The differences were statistically significant (P < 0.05). Conclusion Pacing in RVOTs in patients with SSS could offer better cardiac function and hemodynamics effect than pacing in RVA , but is still not better than atrial pacing.