超声指导下优化心脏再同步化治疗患者AV间期的即刻及短期疗效  

Immediate and Short-term Effects of AV-delay Optimization in Patients with Cardiac Resynchronization Therapy by Echocardiography

作　　者：张军[1] 李金芳[1] 刘丽文[1] 张海滨[1] 朱永胜[1] 王红梅[1] 刘兵[2] 

机构地区：[1]解放军第四军医大学西京医院超声诊断科,西安市710032 [2]解放军第四军医大学西京医院心血管内科,西安市710032

出　　处：《中国超声医学杂志》2010年第2期128-131,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的观察超声指导下AV间期优化对心脏再同步化治疗(CRT)患者血流动力学变化的影响及短期疗效。方法 24例行CRT的慢性心力衰竭患者随机分成优化组和对照组各12例,术后3个月以上在超声指导下应用Ritter公式法进行AV间期优化,优化结束时对照组恢复初始AV间期。所有患者优化后1个月随访。结果优化组AV间期优化即刻及1个月后随访较优化前左心室充盈时间延长[充盈时间:(453±86.6)ms、(490.5±122.4)ms vs(396.6±126.7)ms,P<0.05],优化后1个月左心室内径进一步减小,收缩功能略提高(67.4±8.28)vs(71.08±8.52)mm,(27.58±6.05)% vs(25.50±6.99)%,P<0.05];对照组AV间期优化即刻较优化前左心室充盈时间延长,恢复初始AV间期后1个月左心室充盈时间、左心室内径及收缩功能较优化前差异没有统计学意义。结论超声指导下AV间期优化能够改善左心室的收缩和舒张功能,进一步提高CRT疗效。Objective To observe the effect of optimizing the atrioventricular （AV） delay on the hemodynamics as well as the short-term efficacy in patients with cardiac resynchronization therapy by echocardiography. Methods Twenty-four patients with chronic heart failure who had received cardiac resynchronization therapy （CRT） were divided into optimization group and control group randomly. The optimal AV delay was tested by echocardiography using Ritter＇s method more than three months after CRT. The parameters of the patients in control group were restored to the initial settings after optimization. Follow-up （FU） was conducted one month later. Results In optimization group the left ventricular filling time （LVFT） significantly increased immediately after optimization and at FU （LVFT： 453±86.6ms, 490.5±122.4ms vs396.6±126.7ms, P〈0.05） . The left ventricular end-diastolic diameter （LVEDD） decreased and there was a slightly increase of the LV-eiection fraction （LVEF） at FU （67.4±8.28） mm vs （71.08±8.52） mm, 27. 58±6.05% vs. 25.50±6.99%, P〈0.05） . In control group the LVFT significantly increased immediately after optimization but not at FU. The LVEDD and LVEF did not change significantly at FU. Conclusions Optimization of AV-delay by echocardiography can improve the systolic and diastolic function and further enhance the efficacy of CRT.

关 键 词：超声心动图 心脏再同步化治疗 AV间期优化 慢性心力衰竭 

分 类 号：R445.1[医药卫生—影像医学与核医学] R541.6[医药卫生—诊断学]