CRT术后极短期心功能改变与中长期反应性的相关性

郭兰燕; 张敏霞; 胡淼阳; 杨华; 刘兵; 沈敏; 程何祥

doi:10.12125/j.chj.201808021

CRT术后极短期心功能改变与中长期反应性的相关性

Correlation of LVEF after CRT treatment for 5 days and the mid-long term responsiveness

摘要

摘要:
目的通过复查心脏再同步化治疗（cardiac resynchronization therapy，CRT）术后极短期内的心脏超声，评估双心室同步起搏的效果以及与CRT术后中长期反应的相关性。
方法收集行CRT-P/D，术后平均5 d内（简称术后）复查了心脏彩超、心电图、脑钠尿肽前体（pro-BNP）等相关检查，且完成起搏器门诊首次随访（随访1，平均术后2个月）和二次随访（随访2，平均术后6个月），包括心脏彩超、心电图等辅助检查的18例患者。
结果 18例入选患者平均随访6个月时，4例（22%）为超反应，7例（39%）为无反应，11例（61%）为有反应（包括超反应）。CRT有反应和无反应组在性别、年龄、扩心病、心脏大小和心功能等方面均无统计学差异CRT有反应组术后左室射血分数（LVEF）与术前、随访1和随访2的LVEF均有显著差异（P<0.05或P<0.01）；而无反应组以上均无统计学差异。相关分析提示术后LVEF与随访1和随访2的LVEF值显著正相关，与体质量指数（BMI）呈负相关（均P<0.05）。
结论术后极短期心功能LVEF值的变化与CRT术后中长期的反应性可能相关。

Abstract:
AIM Echocardiography results, after CRT implantation for 5 days, to estimate the effects of biventricular pacing and correlations with the mid-long term responsiveness of CRT.
METHODS We collect 18 patients received CRT-P/D implantation who all conducted echocardiography (Echo)、12-leads surface electracardiogram (ECG)、Pro-BNP and so on before implantation and 5 days after procedure（post-implantation）, also completed the first visit (visit1, 2 months after CRT) and the second visit (visit2, 6 months after CRT) in clinic.
RESULTS Among all the collected patients, 11 were the responders, including 4 super-responders, and the left 7 were the non-responders. There existed no evident difference in sex、age、DCM、heart size and heart function between the two groups. There existed evident difference between post-EF and pre-EF/visit1 EF/visit2 EF in the responders group (all P<0.05), otherwise, no difference was observed between the above parameters in non-responders group. Correlation analysis showed that LVEF of post-implantation was positively correlated to LVEF of visit 1 and visit 2, and negatively to BMI (all P<0.05).
CONCLUSION The change of post-LVEF correlated with the mid-long term CRT response in some extent.

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