心脏再同步治疗后右心室收缩功能的变化  

Effect of cardiac resynchronization therapy on right ventricular systolic function in patients with chronic heart failure

作　　者：陈亚宁[1] 吴强[1] 俞杉[1] 安亚平[1] 卜婕[1] Chen Yaning;Wu Qiang;Yu Shan;An Yaping;Bu Jie(Department of Cardiology,Guizhou Province People’s Hospital,Guiyang 550002,China)

机构地区：[1]贵州省人民医院心内科,贵阳550002

出　　处：《中华心律失常学杂志》2020年第4期402-405,共4页Chinese Journal of Cardiac Arrhythmias

摘　　要：目的本研究旨在探索慢性心力衰竭患者接受心脏再同步治疗(CRT)后右心室形态、心肌收缩力、左心室同步性的改变,以定量评估其对右心室功能改善的效果。方法入选2015年1月至2018年1月于贵州省人民医院心内科符合CRT适应证的患者,通过四维右心室容积定量分析测量32例CRT患者术前,术后3、6、12个月右心室基底部横径、右心室中部横径、右心室长径、右心室舒张末期容积、右心室收缩末期容积、右心室射血分数、左心室射血分数、左心室16个节段的面积追踪达峰时间标准差,以评价右心室收缩功能。结果患者术后6、12个月右心室射血分数分别为44.47%±5.69%、47.13%±5.27%,较术前38.84%±6.58%增加,差异有统计学意义(P<0.05);术后12个月右心室中部横径为(29.52±1.74)mm,较术前(32.22±2.31)mm及术后3个月(31.32±1.63)mm有所减低,差异有统计学意义(P<0.05);术后12个月左心室射血分数为33.90%±6.71%,较术前28.13%±7.98%增加,差异有统计学意义(P<0.05),术后3个月左心室16个节段的面积追踪达峰时间标准差为(134.40±20.69)ms,较术前(156.80±25.27)ms减低,差异有统计学意义(P<0.05)。结论CRT可以改善心力衰竭患者右心室形态及收缩功能。Objective To evaluate right ventricular function in patients with chronic heart failure(CHF)after cardiac resynchronization therapy(CRT)by four-dimensional right ventricular quantitative analysis(4D-RV-Volume).Methods Thirty-two patients who received CRT implantation from January 2015 to January 2018 in Department of Cardiology in Guizhou Province People’s Hospital were included.All patients received echocardiography examination pre-operation,and the 3,6 and 12 months after CRT implantation.4D-RV-Volume indices included right ventricular end-systolic volume(RVESV),right ventricular end-diastolic volume(RVEDV),right ventricular ejection fraction(RVEF).And the left ventricular dyssynchrony data sets included the standard deviation of time to peak tracking in the 16 left ventricular segments(AT-SD).The right ventricular diameters included RV basal transverse diameter(RVD1),RV middle transverse diameter(RVD2)and RV longitudinal diameter(RVD3)in apical four views.And left ventricular ejection fraction(LVEF)were recorded by conventional ultrasound.Results The RVEF at the 6th month(44.47%±5.69%)and the 12th month(47.13%±5.27%)increased when compared with that of pre-operation[38.84%±6.58%(P<0.05)].The RVD2 at the 12th month after implantation[(29.52±1.74)mm]were significantly lower than that at the pre-operation[(32.22±2.31)mm]and 3rd month[(31.32±1.63)mm(P<0.05)].The LVEF at the 12th month after implantation(33.90%±6.71%)were significantly higher than that at the pre-operation[28.13%±7.98%(P<0.05)].The AT-SD at the 3rd month[(134.40±20.69)ms]were significantly lower than that the pre-operation[(156.80±25.27)ms(P<0.05)].Conclusion CRT can improve the right ventricular function in patients with CHF.

关 键 词：心脏再同步治疗 右心室收缩功能 四维右心室容积定量分析 

分 类 号：R541.6[医药卫生—心血管疾病]