CAJ | 학술논문

目的：观察右室心尖部起搏患者起搏QRS波时限对心功能的影响。方法76例因Ⅲ度房室阻滞而安装起搏器的患者根据起搏QRS波时限分为A组（pQRSd＜190 ms）52例、B组（pQRSd≥190 ms）24例，术前及术后12个月、24个月检测血浆脑钠肽（BNP）水平，进行心脏多普勒超声检查（ LAD、LVEED、LVESD、LVEF），以心衰事件为终点事件，并进行比较。结果术后12个月，与A组比较，B 组LVEF 明显降低（P＜0．05），2组间LAD、LVEDD、LVESD、血BNP比较无显著性差异；术后24个月，与A组比，B组的LAD、LVSED、LVDED和血BNP明显增高（P＜0．05或0．001），LVEF明显降低（P＜0．001）。整个随访期间，B组比A组心衰再入院率增高，但无统计学差异。结论右室心尖部起搏 QRS波时限的延长可致心脏功能的受损。
목적：관찰우실심첨부기박환자기박QRS파시한대심공능적영향。방법76례인Ⅲ도방실조체이안장기박기적환자근거기박QRS파시한분위A조（pQRSd＜190 ms）52례、B조（pQRSd≥190 ms）24례，술전급술후12개월、24개월검측혈장뇌납태（BNP）수평，진행심장다보륵초성검사（ LAD、LVEED、LVESD、LVEF），이심쇠사건위종점사건，병진행비교。결과술후12개월，여A조비교，B 조LVEF 명현강저（P＜0．05），2조간LAD、LVEDD、LVESD、혈BNP비교무현저성차이；술후24개월，여A조비，B조적LAD、LVSED、LVDED화혈BNP명현증고（P＜0．05혹0．001），LVEF명현강저（P＜0．001）。정개수방기간，B조비A조심쇠재입원솔증고，단무통계학차이。결론우실심첨부기박 QRS파시한적연장가치심장공능적수손。
Objective It is to observe the effect of paced QRS duration on heart function in patients with right ventricular apical pacing .Methods 76 patients with Ⅲ°atrioventricular block receiving pacemaker treatment were enrolled and stratified to group A(pQRSd<190 ms,n=52) and groupB(pQRSd≥190 ms,n=24).The concentration of brain natriuretic peptide ( BNP) was determined , left atrial diameter ( LAD) ,left ventricular ejection fracetion ( LVEF) ,left ventricular end diastolic di-ameter(LVEDD),left ventricular end systolic dimension (LVEDD) were measured by heart Dropper ultrasound before opera-tion and in 12-month and 24-month after implanting .The primary outcome was heart failure event during follow-up.The indexes mentioned above were compared respectively .Results At 12-month after implanting , LVEF of the patients in the group B de-creased significantly compared with that of groupA (P<0.05),other echocardiography paramenters and the concentration of BNP were not significantly different between the two groups (P>0.05).After 24-month,LAD, LVEDD, LVESD and the con-centration of BNP of group B increased significantly compared with that of groupA , LVEF of the patients in the group B de-creased significantly compared with that of group A (P<0.001).There was no significant difference in the incidence of heart failure event between two groups during 24-month follow-up.Conclusion The prolonged paced QRS duration has a detrimental effect on long-term cardiac function during RVA pacing in patients with atrioventricular block .