超声心动图在心脏再同步化治疗室间间期优化中的应用  

Interventricular delays optimization of cardiac resynchronization therapy:observation with echocardiography

作　　者：骆志玲[1] 郭涛[1] 顾云[1] 倪锐志[1] 王钰[1] 沈艳[1] 陆永萍[2] 

机构地区：[1]昆明医学院第一附属医院心内科,云南昆明650031 [2]云南省第二人民医院超声科,云南昆明650030

出　　处：《中国医学影像技术》2009年第3期419-422,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨超声心动图在心脏再同步化治疗(CRT)室间间期(VVD)优化中的价值。方法7例CRT患者行VVD优化,比较不同VVD的超声心动图指标的即刻差异。结果7例中左心室优先优于右心室优先和双室同步起搏:左心室优先时超声心动图测量的心功能指数(Tei指数)、左右心室射血前期延迟(PETd)、左心室壁12节段收缩达峰速时间标准差(TS-12-SD)、左心室收缩后收缩(PSS)减小,左心室收缩期压力上升速率(dp/dt)、主动脉流速时间积分(VTIAV)增大(P均<0.05);左心室射血分数(EF)增高,但差异无统计学意义;双室同步起搏与右心室起搏的超声心动图各项指标均差异无统计学意义(P均>0.05)。最优VVD分布在10～30ms,但个体差异明显。结论超声心动图指导下CRT患者VV间期优化可使CRT患者获得即刻血流动力学指标改善。Objective To explore the value of VV optimizing of cardiac resynehronization therapy （CRT） by echocardiography. Methods Seven in-patients with congestive heart failure receiving VV delays optimization were observed with echocardiography, and the immediate differences of echoeardiographie parameters at different VV intervals were recorded. Results LV pre-activation was superior to simultaneous and RV pre-activation. Under such condition, Tel index, PETd, TS-12-Sd and PSS decreased, while dp/dt and VTI_AV increased （P〈0.05）. There was no obvious difference between simultaneous pacing and RV pre-activation measured with echocardiography （P〉0.05）. LV pre-activation delay ranged from 10 ms to 30 ms, hut there was individual variability. Conclusion Immediate improvement of hemodynamic is available in CRT patients undergoing optimization of VV delays under the supervision of echocardiograph.

关 键 词：心脏再同步化治疗 超声心动描记术 VV间期优化 即刻疗效 

分 类 号：R540.45[医药卫生—心血管疾病] R541[医药卫生—内科学]