摘要
目的研究冠心病患者长期右室间隔起搏对心脏结构功能的影响及两者之间的相关性。方法选择2008至2013年行起搏器植入治疗并将心室电极置入右室间隔的患者132例,根据冠脉造影结果分为冠心病组(56例)和非冠心病组(76例),对比两组起搏器植入5年前后的左心房内径(LA)、左心室舒张末内径(LVIDd)、室间隔厚度(IVSd)、左心室后壁厚度(LVPWd),射血分数(EF)及各瓣膜病变发病率的变化,采用Pearson相关分析检验心室起搏比例(VP%)和心脏彩超结果之间的相关性。结果起搏器植入5年后,冠心病患者的LA、IVSd、LVPWd均大于植入前(均P<0.01);EF低于植入前(P<0.01);二尖瓣反流、三尖瓣反流、肺动脉高压的发生率均高于植入前(均P<0.01)。起搏器植入5年后,非冠心病患者的LA大于植入前(P<0.01);三尖瓣反流的发生率高于植入前(P<0.01)。VP%与LVIDd(P=0.001)、IVSd(P<0.001)、EF(P=0.005)、二尖瓣反流(P=0.006)均显著相关。结论冠心病患者在右室间隔起搏5年后心脏的结构及功能均有明显改变,且与右室间隔起搏的比例明显相关。
Objective To investigate the relationship between long-term right ventricular septal pacing and cardiac remodeling in patients with coronary heart disease(CAD).Methods One hundred and thirty two patients with coronary heart disease who had long-term pacemaker implantation in the right ventricular septum during 2008 to 2013 were enrolled in this study.According to the result of coronary angiography they were divided into CAD(+)group(n=56)and CAD(-)group(n=76).The LA,LVIDd,IVSd,LVPWd,EF,morbidity of mitral regurgitation,tricuspid regurgitation,aortic regurgitation and pulmonary artery hypertension were compared between two groups after 5 years of the pacemaker implanted.Results After 5 years of the pacemaker implantation,there were enlarged LA,LVIDd,LVMI,decreased EF,and increased morbidity of mitral regurgitation,tricuspid regurgitation,pulmonary artery hypertension in CAD(+)group,compared with those before implantation.And the change of LVIDd,IVSd,EF,morbidity of mitral regurgitation were correlated with the right ventricular septal pacing.Only the enlarged LA and increased morbidity of mitral regurgitation were found in CAD(-)group.Conclusion After 5 years of the pacemaker implanted,the patients with coronary heart disease had significant changes of cardiac structure and function,and the changes are correlated with the right ventricular septal pacing.
作者
林丛
林媛媛
邹贺
林加锋
LIN Cong;LIN Yuanyuan;ZOU He(Department of Cardiology,Wenzhou Third Institute of Wenzhou Medical University,Wenzhou 325000,China)
出处
《浙江医学》
CAS
2019年第4期337-339,344,共4页
Zhejiang Medical Journal
关键词
冠心病
起搏器
心力衰竭
Coronary heart disease
Pacemaker
Heart failure
