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《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:

2011年第6期

页码:

741-743，747

栏目:

临床研究

出版日期:

2011-12-25

文章信息/Info

Title:

Effects of left ventricular geometry and postoperative blood pressure changes on efficacy of cardiac resynchronization therapy

作者:

惠玲玲¹; 张卫泽²; 陈永清²; 马 凌²; 韩娟萍²; 张玉秀²

1.第四军医大学西京医院心内科，陕西 西安 710032；2.兰州军区兰州总医院心内科，甘肃 兰州 730050

Author(s):

HUI Ling-ling¹;  ZHANG Wei-ze²;  CHEN Yong-qing²;  MA Ling²;  HAN Juan-ping²;  ZHANG Yu-xiu²

1.Department of Cardiology, Xijing Hospital, Fourth Military Medical University, Xi’an 710032, Shaanxi, China; 2.Department of Cardiology, Lanzhou General Hospital, Lanzhou Military Area Command, Lanzhou 730050, Gansu, China

关键词:

心脏再同步化治疗; 心力衰竭; 超声心动图; 收缩压

Keywords:

cardiac resynchronization therapy;  Cardiac resynchronization therapy responders;  Coronary heart failure;  echocardiogram;  Systolic blood pressure

分类号:

R541.61

DOI:

-

文献标识码:

A

摘要:

目的:观察左心室（LV）大小和术后急性期收缩压（SBP） 变化对心脏再同步化治疗（CRT ）疗效的影响。方法: 分别于术前及术后 6 个月评估21例CRT患者的心功能及超声参数。至术后 6个月时，NYHA 至少下降1级，左室收缩末容积（LVESV）至少降低10%的为CRT反应较好组，余为反应较差组。结果: 术后6个月时，反应较好组和其基线期相比左室射血分数（LVEF）显著升高［（32±9）% vs. (45±10)%，P<0.05）］、左室舒张末容积（LVEDV）显著降低［（237±54）ml vs. (151±45) ml，P<0.05］、左室舒张末内径（LVEDD）显著降低［（68±8） mm vs. (55±6) mm，P<0.05］、左室收缩末容积（LVESV）显著降低［（165±46） ml vs. (84±31) ml，P=0.01］、NYHA 的分级由术前6/8（III/IV）降至术后11/3(II/III)；反应较差组和术前相比有所改善，未达到统计学意义。反应较好组术后7d SBP均显著升高（P<0.05）,反应较差组下降。结论: 心力衰竭患者CRT治疗反应较好与治疗前左心室较小和术后急性期SBP升高有关联性。

Abstract:

AIM:To study the effects of left ventricular (LV) geometry and postoperative systolic blood pressure (SBP) changes on the efficacy of cardiac resynchronization therapy (CRT). METHODS: Twenty-one CRT recipients were included in the study. Before CRT and 6 months after, clinical and echocardigraphic evaluations were performed. At 6 months after CRT, the patients with a decrease of NYHA≥1 and a decrease of LVESV ≥10% were classified as CRT-responders and the others were classified as CRT-nonresponders. RESULTS: At baseline, no significant difference was observed in all patients except that CRT-responders had smaller LVEDD and better renal function. At 6 months after CRT, LVEF increased ［(32±9)% vs. (45±10)%, P<0.05］, whereas NYHA (6/8, III/IV vs. 11/3, II/III), LVEDD ［(68±8)mm vs.(55±6)mm, P<0.05］, LVEDV ［(237±54)ml vs.(151±45)ml, P<0.05］ and LVESV ［(165±46) ml vs. (84±31), P=0.01］ decreased in CRT-responders. No significant improvement was observed in CRT-nonresponders. A marked increase of SBP was found in CRT-responders. CONCLUSION: Less-altered ventricular geometry, smaller LVEDD and a prompt SBP rise just after CRT may predict a better response in CRT recipients.

参考文献/References

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备注/Memo

备注/Memo:

收稿日期：2011-01-22.通讯作者：张卫泽，主任医师，主要从事心脏起搏与电生理研究 Email：zhangweizwz@medmail.com.cn 作者简介：惠玲玲，硕士生Email：huiling.1016@163.com

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更新日期/Last Update: 2011-12-27