杨立波, 贾绍斌, 张华, 刘志军. 动态优化AV/VV间期心脏再同步治疗慢性心力衰竭的临床观察[J]. 心脏杂志, 2011, 23(1): 100-102.
    引用本文: 杨立波, 贾绍斌, 张华, 刘志军. 动态优化AV/VV间期心脏再同步治疗慢性心力衰竭的临床观察[J]. 心脏杂志, 2011, 23(1): 100-102.
    shu
    Short- and mid-term clinical effectiveness of cardiac resynchronization therapy optimized AV/VV delay dynamically for patients with congestive heart failure[J]. Chinese Heart Journal, 2011, 23(1): 100-102.
    Citation: Short- and mid-term clinical effectiveness of cardiac resynchronization therapy optimized AV/VV delay dynamically for patients with congestive heart failure[J]. Chinese Heart Journal, 2011, 23(1): 100-102.
    shu

    动态优化AV/VV间期心脏再同步治疗慢性心力衰竭的临床观察

    Short- and mid-term clinical effectiveness of cardiac resynchronization therapy optimized AV/VV delay dynamically for patients with congestive heart failure

      摘要
    • 摘要: 目的: 观察动态优化AV/VV间期心脏再同步治疗（cardiac resynchronization therapy，CRT）治疗慢性心力衰竭（CHF）的短中期疗效。方法： 12例CHF晚期患者接受CRT治疗，分别于植入前、植入术后3、6个月在超声心动图指导下优化房室（AV）间期和室室（VV）间期，同时观察心腔结构、二尖瓣返流及心电图、脑钠尿肽（BNP）检查等，评价CRT临床疗效。结果： 最佳优化AV间期120～180（158±19）ms和VV间期4～28（16±7）ms，临床症状改善，六分钟步行距离由(257±23)m增加至(344±21)m，QRS时限由（136±17）ms降至(109±12)ms(P<0.01,P<0.05)。植入后左室舒张末内径（LVEDD）较植入前明显缩小［(71±10) mm vs. (54±4),P<0.05］; 左室射血分数（LVEF）提高［(0.308±0.022) vs. (0.531±0.085),P<0.01］；血浆BNP值由植入前（876±415）ng/L降至(70±28)ng/L(P<0.05)。结论： 动态程控AV/VV间期可以提高CRT对CHF患者短、中期疗效。

       

      Abstract: AIM: To observe the short-term and mid-term clinical effectiveness of cardiac resynchronization therapy (CRT) optimized AV/VV delay dynamically for patients with congestive heart failure (CHF). METHODS: Twelve patients with refractory heart failure received CRT device implantation. Pacing parameters were tested and AV/VV interval was optimized by the guidance of echocardiography during the follow-up period. The effectiveness of CRT was evaluated in terms of echocardiography, tissue Doppler, ECG and BNP during the follow-up period. RESULTS: The best optimized AV delay was between 120 msec and 180 msec (158±19)msec and the best optimized VV delay was between 4 msec and 28 msec (16±7)msec. The heart function classification, quality of life, 6-min hall walking distance was significantly increased (257±23)m to (344±21)m. QRS interval decreased from (136±17)msec to (109±12)msec (P<0.05). With significant reduction of left ventricular end-diastolic (LVEDD) ［(71±10)mm vs.(54±4), P<0.05］, the left ventricular ejection fraction (LVEF) increased ［(0.308±0.022) vs.(0.531±0.085), P<0.01］. Plasma BNP decreased from (876±415)ng/L to (70±28)ng/L (P<0.05) and the intra- and inter-ventricular asynchrony indexes were significantly improved. CONCLUSION: Dynamically optimized AV/VV delay of the pacemaker parameters enhances the short- and mid-term effects of CRT.

       

      • HTML全文
      • 参考文献(0)
      • 相关文章
      • 施引文献
    • 资源附件(0)

    /

    返回文章
    返回