不同心脏起搏方式对左室舒张功能的影响  

The Effects of Different Pacing Modes on Left Ventricular Diastolic Function

作　　者：耿登峰[1] 王景峰[1] 

机构地区：[1]中山大学附属第二医院心内科,广东广州510120

出　　处：《中山大学学报（医学科学版）》2003年第2期182-184,共3页Journal of Sun Yat-Sen University:Medical Sciences

摘　　要：[目的]应用超声心动图方法探讨房室序贯同步和心室同步起搏对左室舒张功能的影响。[方法]选择20例植入双腔起搏器患者,应用体外程控仪将每例患者的起搏器随机程控为抑制型按需心室起搏(VVI)、非同步房室起搏(DOO)、抑制型按需心房起搏(AAI)3种起搏方式,应用超声心动图测量左室舒张功能指标。[结果]在20例病人中,VVI起搏仅7例可见到A峰;与AAI和DOO起搏相比,VVI起搏时E峰(0.68±0.19 vs 0.62±0.15 vs0.82±0.16),E/A比值,mAV,mDV和E-VTI均有显著增高(P<0.05),而A峰(0.70±0.26 vs 0.65±0.20 vs0.41±0.09),AFF和IVRT显著降低(P<0.05);与DOO起搏相比,AAI起搏时E峰(0.62±0.15 vs 0.68±0.19)显著升高(P<0.05)。[结论]房室序贯同步和心室同步对左室舒张功能有重要影响;在人工心脏起搏治疗中,对合适的病人选择房室全自动型起搏(DDD)、AAI等符合生理性的起搏器,对改善患者的左室舒张功能有重要意义。[Objective] Assess the effects of atrioventricular synchrony and ventricular synchrony on left ventricular diastolic function with echocardiography. [ Methods ] 20 patients with dual-chamber pacemakers were included in the study. Each pacemakers were programmed randomly to three different pacing modes:AAI,DOO or VVI. Left ventricular diastolic function indexes were measured by echocardiography. [Results] Among 20 patients with VVI only 7 had A wave. Comparing with DOCK AAI, VVI increased E wave(0. 68±0. 19 vs 0. 62±0. 15 vs 0. 82±0. 16),E/A ratio,mAV,mDV and E-VTI signifi-cantly( P < 0. 05),whereas decreased A wave(0. 70 ±0. 26 vs 0. 65±0. 20 vs 0.41±0. 09),AFF and IVRT significantly( P < 0. 05) . Comparing with DOO, AAI increased E wave(0. 62±0. 15 vs 0. 68±0. 19) significantly( P < 0. 05). [Conclusion] Left ventricular diastolic function is affected obviously by atrioventricular synchrony and ventricular synchrony. It is important to select physiological pacemakers that preserve atrioventricular synchrony and ventricular synchrony in cardiac pacing.

关 键 词：人工起搏器 房室序贯同步 心室同步 左心室功能 

分 类 号：R318.11[医药卫生—生物医学工程]