心衰犬单纯左室起搏方式的疗效观察  

Study on the Efficacy of Left Ventricular Pacing of Heart Failure in Dogs

作　　者：黄志辉[1] 甘继宏[1] 沈倩波[1] 蒋银花[2] 严志刚 王巍[1] 王宏军[4] 

机构地区：[1]兰州军区乌鲁木齐总医院心内科,新疆乌鲁木齐834500 [2]兰州军区乌鲁木齐总医院超声科,新疆乌鲁木齐834500 [3]兰州军区68070部队卫生处,甘肃兰州730020 [4]新疆军区69337部队卫生队,新疆托里834700

出　　处：《医学临床研究》2012年第9期1696-1697,1700,共3页Journal of Clinical Research

基　　金：全军医药卫生科研基金课题（课题编号：CWS10JA24）

摘　　要：【目的】评价单纯左室起搏方式治疗心衰的疗效。【方法】建立12只左束支传导阻滞的心衰犬模型，采用自身对照方法随机行右心房一右室心尖部（RVA）、右心房-双心室（Bi—V）、右心房-左室（LV）起搏，起搏频率180次／分钟，每种起搏方式起搏前及起搏稳定15rain后行彩色多普勒超声心动图检查，测定左心／室舒张末期直径（LVEDd）、左室射血分数（LVEF）、室间机械延迟（IVMD）、室间隔与左室后壁运动延迟（SP—wMD）、左心室12个节段达峰时问的标准差（Ts—SD）。【结果】单纯左室起搏时：与起搏前及右室心尖部起搏相比，LVEDd、IVMD、SPWMD、Ts—SD减小，LVEF增大，其差异有显著性（P〈0．05）；与双室起搏相比，上述指标间无显著性差异（P〉0．05）。【结论】单纯左室起搏方式能够改善心室不同步及心功能，可做为心脏再同步化治疗（CRT）心衰的一种选择方式。[Objectivel To evaluate the efficacy of left ventricular pacing for the treatment of heart failure. [Methods] Twelve dogs with heart failure and left bundle branch block were selected. Right atrium right ventricular apex（RVA）, right atrium- biventrieular （Bi-v） and right atrium-left ventricular （LV） were randomly performed by using own control method. The pacing frequency was 180 times per minute. Color Doppler echocardiography was performed before pacing and 15 minutes after the stable pacing. Left ventricular end diastolic diameter（LVEDd）, left ventricular ejection fraction（LVEF）, interventrieular mechanical delay（IVMD）, inter- ventrieular septum and left ventricular posterior wall motion delay（SPWMD ） and left ventricular 12-segment peak time standard deviation（Ts-SD） were measured. [ResultslCompared with before pacing and right ventrie- ular apex pacing, LVEDd, IVMD, SPWMD and Ts-SD decreased and LVEF increased in left ventricular pa- cing, and there was significant difference（ P 〈0.05）. There was no significant difference in above parameter between left ventrieular and biventricular pacing（ P 〉0.05）. [ConclusionlLeft ventricular pacing can improve ventrieular dyssynchrony and cardiac function, so it can be a selection of cardiac resynchronization therapy （CRT） of heart failure.

关 键 词：心力衰竭 充血性 心室 心脏起搏 人工 狗 

分 类 号：R541.61[医药卫生—心血管疾病]