中华心律失常学杂志
中華心律失常學雜誌
중화심률실상학잡지
CHINESE JOURNAL OF CARDIAC ARRHYTHMIAS
2009年
1期
13-15
,共3页
徐伟%李晓宏%孙步高%张宁%吉文庆%余洪松%狄文成
徐偉%李曉宏%孫步高%張寧%吉文慶%餘洪鬆%狄文成
서위%리효굉%손보고%장저%길문경%여홍송%적문성
心脏再同步治疗%心力衰竭%组织多普勒
心髒再同步治療%心力衰竭%組織多普勒
심장재동보치료%심력쇠갈%조직다보륵
Cardiac resynchronization therapy%Heart failure%Tissue Doppler imaging
目的 观察心脏再同步治疗(CRT)对慢性心力衰竭的长期临床疗效.方法 24例接受CRT的慢性心力衰竭患者,心功能Ⅲ～Ⅳ级(NYHA分级),左心室射血分数(LVEF)≤0.35,左心室舒张末内径(LVEDD)≥55 mm,QRS时限≥120 ms.植入前超声心动图及组织多普勒检查以评价心功能及心脏收缩不同步指标,并指导左心室电极导线的植入.植入后3、6个月及随后的每6个月进行随访,随访内容包括临床症状、心电图、LVEDD、LVEF及多普勒超声评价心脏收缩同步性指标.结果 随访时间(12.0±4.6)个月,结果显示患者临床症状明显改善,QRS时限植入后较植入前缩短[(137.50±38.96)ms对(144.60±45.78)ms,P=0.67],但差异无统计学意义.植入后LVEDD较植入前明显缩小[(6.24±0.89)cm对(6.78±0.42)cm,P=0.03];LVEF则明显提高(0.36±0.09对0.31±0.03,P<0.01),左心房内径(LAD)也较术前明显缩小[(4.22±8.43)cm对(5.32±7.63)cm,P=0.01].心脏收缩不同步指标与植入前相比也明显改善.结论 对慢性心力衰竭的患者,CRT治疗可改善左心室功能,逆转左心室重构.
目的 觀察心髒再同步治療(CRT)對慢性心力衰竭的長期臨床療效.方法 24例接受CRT的慢性心力衰竭患者,心功能Ⅲ～Ⅳ級(NYHA分級),左心室射血分數(LVEF)≤0.35,左心室舒張末內徑(LVEDD)≥55 mm,QRS時限≥120 ms.植入前超聲心動圖及組織多普勒檢查以評價心功能及心髒收縮不同步指標,併指導左心室電極導線的植入.植入後3、6箇月及隨後的每6箇月進行隨訪,隨訪內容包括臨床癥狀、心電圖、LVEDD、LVEF及多普勒超聲評價心髒收縮同步性指標.結果 隨訪時間(12.0±4.6)箇月,結果顯示患者臨床癥狀明顯改善,QRS時限植入後較植入前縮短[(137.50±38.96)ms對(144.60±45.78)ms,P=0.67],但差異無統計學意義.植入後LVEDD較植入前明顯縮小[(6.24±0.89)cm對(6.78±0.42)cm,P=0.03];LVEF則明顯提高(0.36±0.09對0.31±0.03,P<0.01),左心房內徑(LAD)也較術前明顯縮小[(4.22±8.43)cm對(5.32±7.63)cm,P=0.01].心髒收縮不同步指標與植入前相比也明顯改善.結論 對慢性心力衰竭的患者,CRT治療可改善左心室功能,逆轉左心室重構.
목적 관찰심장재동보치료(CRT)대만성심력쇠갈적장기림상료효.방법 24례접수CRT적만성심력쇠갈환자,심공능Ⅲ～Ⅳ급(NYHA분급),좌심실사혈분수(LVEF)≤0.35,좌심실서장말내경(LVEDD)≥55 mm,QRS시한≥120 ms.식입전초성심동도급조직다보륵검사이평개심공능급심장수축불동보지표,병지도좌심실전겁도선적식입.식입후3、6개월급수후적매6개월진행수방,수방내용포괄림상증상、심전도、LVEDD、LVEF급다보륵초성평개심장수축동보성지표.결과 수방시간(12.0±4.6)개월,결과현시환자림상증상명현개선,QRS시한식입후교식입전축단[(137.50±38.96)ms대(144.60±45.78)ms,P=0.67],단차이무통계학의의.식입후LVEDD교식입전명현축소[(6.24±0.89)cm대(6.78±0.42)cm,P=0.03];LVEF칙명현제고(0.36±0.09대0.31±0.03,P<0.01),좌심방내경(LAD)야교술전명현축소[(4.22±8.43)cm대(5.32±7.63)cm,P=0.01].심장수축불동보지표여식입전상비야명현개선.결론 대만성심력쇠갈적환자,CRT치료가개선좌심실공능,역전좌심실중구.
Objective To observe the long-term effects of cardiac resynchronization therapy(CRT)in patients with congestive heart failure(CHF).Methods Twenty-four patients fulfilled the CRT indication with New York Heart Association(NYHA)Ⅲ～Ⅳ,QRS duration≥120 ms,LVEF≤0.35,LVEDD≥55 mm were studied by echocardiography before and after resynchronization.Intra-ventricular and inter-ventricular asynchrony were assessed by tissue Doppler imaging(TDI).Patients were followed up 3,6 monthes and every 6 monthes after operation.Results Patients were followed up for(12.0 ±4.6)months,with significant reduction of left ventricular end-diastolic(LVEDD)[(6.24±0.89)cm vs(6.78 ±0.42)cm,P=0.03]and left atrail dimension(LAD)[(4.22±8.43)cm vs(5.32±7.63)cm,P=0.01].The left vertricular ejection fraction (LVEF)Was increased(0.36±0.09 vs 0.31±0.03,P<0.01).The intra-ventricular and inter-ventricular asynchrony indexes were significantly improved.Conclusion CRT improves the LV systolic function associated with the LV reverse remodeling.
