摘要
目的筛选超声心动图评估希氏束起搏(HBP)治疗慢性心力衰竭(CHF)伴左束支传导阻滞(LBBB)疗效的指标。方法回顾性分析28例CHF伴LBBB患者HBP术前及术后1、3、6个月超声心动图,二维参数包括左心房前后径(LAD)、左心室舒张末期内径(LVEDD)、心室间机械延迟(IVMD)时间及二尖瓣最大反流面积,三维参数包括左心室射血分数(LVEF)、左心室舒张及收缩末期容积(LVEDV、LVESV)、每搏量(LVSV)、左心室16节段达最小收缩容积时间最大差(Tmsv16-Dif%)和标准差(Tmsv16-SD%)。结果术后1、3、6个月LAD、LVEDD、LVSV、LVEDV、LVESV、IVMD、Tmsv16-SD%及Tmsv16-Dif%均低于术前(P均<0.05),而LVEF高于术前(P<0.01)。术后6个月LVSV、LVEDV、LVESV及IVMD均低于术后1个月(P均<0.05),LVEF高于术后1个月(P<0.01)。术后6个月71.43%(20/28)患者二尖瓣反流程度较术前改善。结论HBP治疗CHF伴LBBB效果良好;LVEF、IVMD、Tmsv16-SD%、Tmsv16-Dif%及MR改善是超声心动图评估HBP疗效的敏感指标。
Objective To screen the indexes of ultrasound for evaluation on therapeutic effect of His bundle pacing(HBP)in patients with chronic heart failure(CHF)and left bundle-branch block(LBBB).Methods Echocardiographic parameters of 28 CHF-LBBB patients before and 1,3 and 6 months after HBP were retrospectively analyzed,including two-dimensional indexes as left atrium diameter(LAD),left ventricular end diastolic diameter(LVEDD),interventricular mechanical delay(IVMD)time and mitral regurgitation(MR),also three-dimensional echocardiographic parameters as left ventricular ejection fraction(LVEF),left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV),left ventricular stroke volume(LVSV),the maximum difference and standard deviation of left ventricle 16 segments reached time to minimum systolic volume(Tmsv16-Dif%and Tmsv16-SD%).Results One,3 and 6 months after HBP,LAD,LVEDD,LVSV,LVEDV,LVESV,IVMD,Tmsv16-Dif%and Tmsv16-SD%were all lower than those before HBP(all P<0.05),while LVEF was higher than those before HBP(P<0.01).Compared with 1 month after HBP,LVSV,LVEDV,LVESV and IVMD 6 months after HBP were all lower(all P<0.05),while LVEF was than higher(P<0.01).Six months after HBP,MV was improved in 71.43%(20/28)patients.Conclusion CHF complicated with LBBB could be effectively treated with HBP.LVEF,IVMD,Tmsv16-Dif%,Tmsv16-SD%and MR improvement were sensitive indicators for postoperative evaluation with echocardiography.
作者
吴沛营
周微微
焦晓芳
于海波
梁延春
WU Peiying;ZHOU Weiwei;JIAO Xiaofang;YU Haibo;LIANG Yanchun(Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China)
出处
《中国介入影像与治疗学》
北大核心
2021年第4期212-215,共4页
Chinese Journal of Interventional Imaging and Therapy
基金
辽宁省自然科学基金(20180550235)
辽宁省第一批次科学技术计划(2011225021)。
