摘要
目的分析起搏器植入术后起搏诱导性心肌病(pacing induced cardiomyopathy,PICM)的临床特征和相关因素。方法2008年1月至2013年12月温州市人民医院心内科行起搏器植入且术前左心室射血分数(LVEF)>50%的患者204例,根据术后随访心脏超声结果分为PICM组和非PICM组,比较两组起搏器植入前后心脏超声、心电图数据及起搏器程控数据,分析PICM的危险因素及对患者远期预后的影响。结果204例植入起搏器的患者中,PICM组26例,非PICM组178例,PICM发病率为12.7%。与非PICM组患者比较,PICM组术前左心室舒张末期内径(LVEDd)、左心室收缩末期内径(LVESd)和左心室质量指数(LVMI)较大,LVEF较低,术后心电图起搏QRS时间较长,心室起搏比例较高,差异均有统计学意义(均P<0.05)。其中起搏QRS时间(>155.5 ms),心室起搏比例(>28.5%)及术前LVMI(>129.1 g/m2)均为PICM的危险因素(均P<0.05)。PICM组术后心力衰竭住院率较高(P<0.05)。结论起搏QRS时间、心室起搏比例及LVMI与PICM的发生有关。
Objective To analyze the clinical features and relative factors of pacing induced cardiomyopathy(PICM).Methods 204 patients underwent pacemaker implanted with left ventricular ejection fraction(LVEF)>50%before procedure were enrolled from January 2008 to December 2013.According to echocardiography performed during follow-up,they were divided into PICM group and non-PICM group.The echocardiography and electrocardiography before and after the procedure and pacemaker parameters were compared between the two groups.The factors relative to PICM and prognosis were analyzed.Results Among 204 patients with pacemaker implanted,26 patients were assigned into PICM group and 178 patients into non-PICM group.The incidence of PICM was 12.7%.Left ventricular end diastolic diameter and systolic diameter,left ventricular mass index(LVMI)were significantly higher and LVEF was significantly lower in PICM group than in non-PICM group before the procedure(all P<0.05).Pacing QRS duration and ventricular pacing percentage were significantly higher after procedure in PICM group than non-PICM group(all P<0.05).Pacing QRS duration(>155.5 ms),ventricular pacing percentage(>28.5%)and LVMI(>29.1 g/m2)were risk factors for PICM(all P<0.05).Hospitalization rate was higher in PICM group(P<0.05).Conclusion Pacing QRS duration,ventricular pacing percentage and LVMI are related to the development of PICM.
作者
林丛
林媛媛
张建华
林伟
黄时伟
LIN Cong;LIN Yuanyuan;ZHANG Jianhua;LIN Wei;HUANG Shiwei(Department of Cardiology,Wenzhou People's Hospital,Wenzhou 325000,China)
出处
《心电与循环》
2021年第1期45-48,共4页
Journal of Electrocardiology and Circulation
