CAJ | 학술논문

[目的]探讨右室双部位及双室起搏心衰模型犬急性心功能及心室同步的影响.[方法]选取12只左束支传导阻滞的心衰模型犬,采用自身对照方法随机行右心房‐右室双部位(或双室)起搏,起搏频率180次/分钟,每种方式起搏前及起搏稳定15 min 后行彩色多普勒超声心动图检查,测定左心室舒张末期内径(LVEDd)、左室射血分数(LVEF)、室间机械延迟(IVMD)、室间隔与左室后壁运动延迟(SPWMD)、左心室12个节段达峰时间的标准差(Ts‐SD ).[结果]右室双部位起搏:与起搏前相比,LVEDd 、IVMD 、SPWMD 、Ts‐SD 减小,LVEF 增加,差异有显著性( P <0.05);与双室起搏相比,SPWMD 、Ts‐SD 增加,差异有显著性( P<0.05),LVEDd 、IVMD 、LVEF 差异无显著性( P >0.05).[结论]在改善室间不同步及心功能方面,右室双部位与双室起搏有近似效果,但改善左室内不同步前者不及后者.
[목적]탐토우실쌍부위급쌍실기박심쇠모형견급성심공능급심실동보적영향.[방법]선취12지좌속지전도조체적심쇠모형견,채용자신대조방법수궤행우심방‐우실쌍부위(혹쌍실)기박,기박빈솔180차/분종,매충방식기박전급기박은정15 min 후행채색다보륵초성심동도검사,측정좌심실서장말기내경(LVEDd)、좌실사혈분수(LVEF)、실간궤계연지(IVMD)、실간격여좌실후벽운동연지(SPWMD)、좌심실12개절단체봉시간적표준차(Ts‐SD ).[결과]우실쌍부위기박:여기박전상비,LVEDd 、IVMD 、SPWMD 、Ts‐SD 감소,LVEF 증가,차이유현저성( P <0.05);여쌍실기박상비,SPWMD 、Ts‐SD 증가,차이유현저성( P<0.05),LVEDd 、IVMD 、LVEF 차이무현저성( P >0.05).[결론]재개선실간불동보급심공능방면,우실쌍부위여쌍실기박유근사효과,단개선좌실내불동보전자불급후자.
Objective]To explore the efficacy of right ventricular bifocal vs biventricular pacing for the treatment of heart failure .[Methods] Twelve dogs with heart failure and left bundle branch block were cho‐sen .Right atrial‐right ventricular bifocal(or biventricular) pacing was performed randomly by using own con‐trol method .The pacing frequency was 180 times per minute .Color Doppler echocardiography was performed before pacing and 15 minutes after the stable pacing .Left ventricular end‐diastolic diameter (LVEDd) ,left ventricular ejection fraction (LVEF) ,interventricular mechanical delay (IVMD) ,interventricular septum and left ventricular posterior wall motion delay (SPWMD ) and left ventricular 12‐segment peak time standard devi‐ation(Ts‐SD) were measured .[Results]Compared with before pacing ,LVEDd ,IVMD ,SPWMD and Ts‐SD decreased and LVEF increased after right ventricular bifocal pacing ,and there was significant difference( P <0 .05) .Compared with biventricular pacing ,SPWMD and Ts‐SD increased after right ventricular bifocal pa‐cing ,and there was significant difference( P < 0 .05) .There was no significant difference in LVEDd ,IVMD and LVEF between two pacing modes ( P > 0 .05) .[Conclusion] The efficacy of right ventricular bifocal for improving the interventricular dyssynchrony and cardiac function is similar to biventricular pacing .But the for‐mer for improving the intraventricular dyssynchrony of left ventricle is inferior to the latter .