CAJ | 학술논문

目的观察超声指导下心脏再同步化治疗(CRT)对慢性心力衰竭(CHF)患者的临床疗效.方法选择2008年9月至2012年1月接受CRT的CHF患者35例,于术后1周、3个月、9个月对房室(AV)和室室(VV)间期进行优化,观察术前及术后3、9个月的心功能分级、6min步行距离、QRS时间、左心室射血分数(LVEF)、左心室舒张末期内径(LVEDd)及QRS波群起点距左心室12节段收缩速度峰值的时间标准差(Ts-12SD)、主动脉射血前期时间和肺动脉射血前期时间之差(IVMD)等指标的变化.结果与术前比较,35例患者平均术后心功能分级提高,6min步行距离增加,超声指标如LVEF、LVEDd及Ts-12SD、IVMD等指标明显改善(P<0.01),随访时间延长,获益更显著(P<0.01).结论在超声指导下对AV、VV间期进行优化后行CRT可改善双心室的同步性和心脏功能.
목적관찰초성지도하심장재동보화치료(CRT)대만성심력쇠갈(CHF)환자적림상료효.방법선택2008년9월지2012년1월접수CRT적CHF환자35례,우술후1주、3개월、9개월대방실(AV)화실실(VV)간기진행우화,관찰술전급술후3、9개월적심공능분급、6min보행거리、QRS시간、좌심실사혈분수(LVEF)、좌심실서장말기내경(LVEDd)급QRS파군기점거좌심실12절단수축속도봉치적시간표준차(Ts-12SD)、주동맥사혈전기시간화폐동맥사혈전기시간지차(IVMD)등지표적변화.결과여술전비교,35례환자평균술후심공능분급제고,6min보행거리증가,초성지표여LVEF、LVEDd급Ts-12SD、IVMD등지표명현개선(P<0.01),수방시간연장,획익경현저(P<0.01).결론재초성지도하대AV、VV간기진행우화후행CRT가개선쌍심실적동보성화심장공능.
Objective To evaluate the echo-guided cardiac resynchronization therapy (CRT) for chronic heart failure (CHF) patients. Methods Thirty five CHF patients received CRT, the AV and VV intervals were optimized by echocardiography at 1 week, 3 and 9 months after pacemaker implantation. The echocardiography,heart function classification, distance of 6 min walk test, QRS interval of al patients were evaluated during fol ow-up. Results The levels of NYHA functional class, 6-min walk dis-tance of 35 patients were improved during fol ow-up;the left ventricular ejection fraction (LVEF), left ventricular end-diastolic di-mension (LVEDd), the standard deviation of regional time intervals in 12 left ventricular (Ts-12SD) and interventricular mechanical delay (IVMD) on echocardiography were significantly improved (P<0.01) after device implantation. The improvement of these parameters was more markedly in later than earlier time after implantation (P<0.01). Conclusion CRT can improve the biventric-ular mechanical synchrony and cardiac function with AV/VV delay optimization guided by echocardiography.