比较左束支区域起搏与右室间隔部起搏对三尖瓣反流的影响  

Comparison of the influence of left bundle area branch pacing and right ventricular septum pacing on tricuspid regurgitation

作　　者：姚云婕[1] 李柯蓓[1] 盛宇峰 宋爱萍[2] 任骋[1] 徐春明[1] YAO Yunjie;LI Kebei;SHENG Yufeng;SONG Aiping;REN Cheng;XU Chunming(Department of Cardiology,2 Department of Ultrasound,Zhangjiagang Hospital Affiliated to Soochow University,Zhangjiagang First People's Hospital,Zhangjiagang,Jiangsu,215638,China)

机构地区：[1]苏州大学附属张家港医院(张家港市第一人民医院)心血管内科,江苏张家港215638 [2]苏州大学附属张家港医院(张家港市第一人民医院)超声科

出　　处：《临床心血管病杂志》2024年第2期150-154,共5页Journal of Clinical Cardiology

基　　金：苏州市民生科技项目(No:SYSD2019003,SYSD2020005);苏州市卫生健康委员会科技项目(No:LCZX202219)。

摘　　要：目的:探索左束支区域起搏(LBBAP)与右室间隔部起搏(RVSP)两种不同起搏模式对三尖瓣反流(TR)的影响。方法:本研究为回顾性观察性研究,纳入2018年1月—2021年8月在张家港市第一人民医院因缓慢性心律失常首次植入心脏永久起搏器,且术前2周内与术后1年以上超声心动图资料齐全的患者。根据心室电极植入部位的不同分为LBBAP组及RVSP组。分析并比较两组术后TR程度。结果:共入组104例患者,男性69例(66.3%),中位随访时间28.5(17~36.75)个月。其中LBBAP组52例,RVSP组52例。术后TR加重的共有21例(20.2%),新发TR共10例(9.6%)。其中LBBAP组TR加重的共10例,RVSP组TR加重的共11例,组间比较差异无统计学意义(P=0.807和1.0)。同时观察到LBBAP组术前19例存在轻度以上的TR,术后有14例(73.7%)患者发生TR减轻,RVSP组术前17例存在轻度以上的TR,术后有6例(35.3%)患者发生TR减轻,组间比较差异有统计学意义(P=0.021)。结论:术前即存在TR的患者,LBBAP术后对原有TR的改善程度明显优于RVSP。Objective:To explore the influence of left bundle branch area pacing(LBBAP)and right ventricular septum pacing(RVSP)on tricuspid regurgitation(TR).Methods:This retrospective observational study included patients who received permanent cardiac pacemaker implantation for the first time due to bradycardia in the First People's Hospital of Zhangjiagang from January 2018to August 2021,and whose echocardiogram data were complete within 2weeks before operation and more than 1year after operation.The patients were divided into LBBAP group and RVSP group.The postoperative effects on TR were analyzed and compared.Results:A total of 104patients were enrolled,including 69males(66.3%).The median follow-up time was 28.5months.There were 21 patients(20.2%)with aggravated TR and 10patients(9.6%)with new TR.There were 10cases of TR aggravation in LBBAP group and 11cases of TR aggravation in RVSP group,without statistical difference(P=0.807or 1.0).Meanwhile,19patients in the LBBAP group had mild or above TR before operation,and 14patients(73.7%)had reduced TR after operation;17patients in the RVSP group had mild or above TR before operation,and 6patients(35.3%)had reduced TR after operation.There was statistical difference between the two groups(P=0.021).Conclusion:The LBBAP is recommended especially for patients with TR before operation.

关 键 词：左束支区域起搏 右室间隔部起搏 三尖瓣反流 心脏起搏器 

分 类 号：R541.7[医药卫生—心血管疾病]