实时三维超声心动图评价右心室不同部位起搏对左心房收缩功能的影响

发布时间：2018-04-30 13:39

本文选题：房室传导阻滞 + 超声心动描记术　；参考：《中国医学影像学杂志》2015年05期

【摘要】：目的运用实时三维超声心动图评价房室顺序型心脏起搏器的右心室间隔部(RVS)起搏及心尖部(RVA)起搏对房室传导阻滞患者左心房收缩功能的影响。资料与方法 51例具备埋藏式心脏起搏器植入适应证的房室传导阻滞患者采用掷硬币法随机分为RVS组31例和RVA组20例,应用实时三维超声心动图测定患者植入房室顺序型心脏起搏器术前、术后1个月、3个月、6个月及12个月的左心房最小容积(LAVmin)、左心房最大容积(LAVmax)、左心房收缩前容积(LAVprep)、左心房总射血分数(LATEF)及左心房主动射血分数(LAAEF)。结果两组LAVmin于术后3个月开始较术前和术后1个月降低(RVA组:t=2.97、2.74,P0.05;RVS组:t=3.24、2.86,P0.05);RVA组自术后6个月开始、RVS组自术后3个月开始,LAVprep均较术前缩小(RVA组:t=3.20,P0.05;RVS组:t=2.71,P0.05);两组LATEF和LAAEF均于术后3个月开始较术前提高(RVA组:t=2.87、9.68,P0.05;RVS组:t=3.56、8.22,P0.05);RVS组术后6个月、12个月的LATEF和LAAEF均大于同时间点的RVA组(t=2.90、5.22、3.03、3.55,P0.05)。结论房室顺序起搏有利于房室传导阻滞患者左心房收缩功能的恢复,RVS起搏较RVA起搏可以更大幅度地提升患者左心房射血分数。
[Abstract]:Objective to evaluate the effects of RVS (right ventricular septum) pacing and apical RVA (apical) pacing on left atrial systolic function in patients with atrioventricular block (AVB) by real time three dimensional echocardiography. Materials and methods 51 patients with atrioventricular block (AVB) who had indications for implantation of implantable pacemakers were randomly divided into RVS group (n = 31) and RVA group (n = 20). Real time three dimensional echocardiography was used to determine the preoperative implantation of sequential atrioventricular pacemakers. At 1 month, 3 months, 6 months and 12 months after operation, the minimum volume of left atrium (LAVmin), the maximal volume of left atrium (LAVmax1), the presystolic volume of left atrium (LAVprepen), the total ejection fraction of left atrium (LATEFF) and the left atrial active ejection fraction (LAAEF1) were measured. Results LAVmin in both groups were lower than those before operation and one month after operation. In RVS group, LATEF and LAAEF were decreased from 3 months after operation to 2. 72.72.74% and 3 months after operation. Both LATEF and LAAEF in RVS group were reduced by 3 months after operation, and LATEF and LAAEF in RVS group were all decreased by 3 months after operation compared with those in RVS group before operation. The LATEF and LAAEF in RVS group were 3. 71a and 3. 71p 0. 05% P 0. 05%, respectively, after operation, 3 months after operation, both LATEF and LAAEF in RVVS group were reduced from 3 months after operation to that in RVS group (P < 0. 05). After 6 months of operation, the LATEF and LAAEF in RVA group were higher than those in RVA group at the same time point. The LATEF and LAAEF were higher than those in RVA group at the same time point (5.223.033.5N, P0.05P 0.05N). The results showed that the LATEF and LAAEF of RVS group were higher than those of RVA group at the same time point (P 0.05), and the LATEF and LAAEF of RVS group at 12 months after operation were higher than those of RVS group (P < 0.05). Conclusion the sequential pacing of atrioventricular pacing is beneficial to the recovery of left atrial systolic function in patients with atrioventricular block. Compared with RVA pacing, RVs pacing can significantly improve the left atrial ejection fraction in patients with atrioventricular block.
【作者单位】：贵州省人民医院心内科;贵阳医学院附属人民医院心内科;
【基金】：贵州省优秀科技教育人才省长资金项目(2012-12)
【分类号】：R540.45;R541.7

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