左束支区域起搏与右心室间隔起搏技术对老年患者左心室收缩同步性、心功能的影响  

Effects of Left Bundle Branch Regional Pacing and Right Ventricular Septal Pacing on Left Ventricular Systolic Synchrony and Cardiac Function in Elderly Patients

作　　者：邓华[1] 李凌 朱丹[1] DENG Hua;LI Ling;ZHU Dan(Department of Cardiology,Chenzhou First People's Hospital(The First Affiliated Hospital of Xiangnan University),Chenzhou,Hunan 423099,China)

机构地区：[1]郴州市第一人民医院(湘南学院第一附属医院)心血管内科,湖南郴州423099

出　　处：《岭南心血管病杂志》2024年第5期478-485,共8页South China Journal of Cardiovascular Diseases

基　　金：郴州市科技计划项目(项目编号:Lcyl2021060)。

摘　　要：目的探讨左束支区域起搏与右心室间隔起搏技术对老年患者左心室收缩同步性、心功能的影响。方法回顾性选取2022年2月至2023年3月期间于郴州市第一人民医院心血管内科接受永久性心脏起搏器植入术治疗的80例老年患者的临床资料,根据心脏起搏电极植入部位分为两组,即对照组、观察组各40例。对照组患者于右心室间隔处植入心脏起搏器,观察组患者于左束支区域植入心脏起搏器。分别于患者心脏起搏器植入术后1个月、术后6个月、术后12个月观察各指标变化,包括左心室收缩同步性参数[左心室收缩期纵向应变达峰时间标准差(time to peak longitudinal strain standard deviation,Tls-SD)、最大差值(time to peak longitudinal strain maximum difference,Tls-dif),左心室收缩期径向应变达峰时间标准差(time to peak radial strain standard deviation,Trs-SD)、最大差值(time to peak radial strain maximum difference,Trs-dif),左心室收缩期环向应变达峰时间标准差(time to peak circumferential strain standard deviation,Tcs-SD)、最大差值(time to peak circumferential strain maximum difference,Tcs-dif)]以及心功能指标[左心室射血分数(left ventricular ejection fraction,LVEF)、心排血量(cardiac output,CO)、心脏指数(cardiac index,CI)]、心腔大小[右心房内径(right atrial inner diameter,RAD)、左心房内径(left atrial diameter,LAD)、左心室舒张末期内径(left ventricular end diastolic diameter,LVEDD)、左心室收缩末期内径(left ventricular end systolic diameter,LVESD)]、氨基末端脑钠肽前体(N-terminal pro-brain natriuretic peptide,NT-proBNP)浓度等。于术后12个月测定起搏参数(感知、阈值、阻抗、心室起搏比例),并统计心脏起搏器植入术后12个月内心力衰竭再入院、死亡等不良事件发生情况。结果术后各时间点观察组心功能指标LVEF、CO、CI略高于对照组,但两组比较差异无统计学意义(P>0.05)。术后各时间�Objectives To investigate the effects of left bundle branch regional pacing and right ventricular septal pacing on left ventricular systolic synchrony and cardiac function in elderly patients.Methods Totally 80 elderly patients who received permanent pacemaker implantation in the cardiovascular department of Chenzhou First People's Hospital from February 2022 to March 2023 were selected retrospectively.They were divided into two groups according to the implantation site of cardiac pacemaker electrodes,namely,40 cases in control group and 40 cases in observation group.Patients in control group were implanted with cardiac pacemakers at the right ventricular septum,and patients in observation group were implanted with cardiac pacemakers at the left bundle branch area.The changes in various indicators at 1 month,6 months,and 12 months after the patient's pacemaker implantation surgery were observed,including left ventricular systolic synchronicity parameters[time to peak longitudinal strain standard deviation(Tls SD),time to peak longitudinal strain maximum difference(Tls dif),time to peak radial strain standard deviation(Trs SD),and maximum difference](time to peak radial strain maximum difference,Trs dif)and cardiac function indicators[left ventricular ejection fraction(LVEF),cardiac output(CO),cardiac index(CI),heart cavity size[right atrial inner diameter(RAD),left atrial diameter(LAD),left ventricular end diastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD),the concentration of N-terminal pro-brain natriuretic peptide(NT-proBNP),etc.Pacing param‐eters(perception,threshold,impedance,ventricular pacing ratio)were measured at 12 months after the operation,and adverse events such as heart failure readmission and death were measured within 12 months after pacemaker implantation.Results The cardiac function indexes LVEF,CO and CI of observation group were slightly higher than those of control group at each time point after surgery,but there was no statistical significance between the two groups(P>

关 键 词：左束支区域起搏 右心室间隔起搏 左心室收缩同步性 心功能 

分 类 号：R541.7[医药卫生—心血管疾病]