双心室起搏对慢性心力衰竭患者心肺功能和生活质量的影响

目的:观察双心室起搏对慢性心力衰竭患者心肺功能和生活质量的影响。方法:慢性心力衰竭伴室内传导阻滞患者9例,植入三腔双心室起搏器,比较双心室起搏前、后患者超声心动图检查、心肺功能和生活质量的变化。结果:双心室同步起搏后.患者左室射血分数(%)由术前(21.6±6.7)%增加到(27.3±5.2)%(术后3月,P< 0.05)。(29.5±5.4)%(术后6月,P<0.05);6 min步行距离,由术前(320±97)m增加到(384±103)m(术后3月.P<0.01).(413±110)m(术后6月.P<0.01);峰值氧耗量、氧通气当量(VE/VO2)、二氧化碳通气当量(VE/VCO2)较术前均有显著增加(P<0.05～<0.01);生活质量评分分别改善30%(术后3月,P<0.01),28% (术后6月,P<0.01)。结论:双心室起搏能有效改善慢性心衰患者心肺功能,增加运动贮量,提高生活质量。

Effects of biventricular pacing on cardiopulmonary function and quality of life in patients with congestive heart failure

Objective:To observe the clinical effects of biventricular pacing in patients with congestive heart failure. Methods:The study objects were 9 patients with chronic heart failure and left bundle branch block. All of them received biventricular synchronous pacing and the left ventricular electrode was inserted into the branch of coronary sinus to pace left ventricle. Results:After biventricular synchronous pacing, the echocardiography parameters (including left ventricular ejection fraction, left ventricular end-diastolic diameter,left ventricular end-systolic diameter, left ventricular filling time and the degree of mitral regurgitation) and cardiopulmonary parameters including 6 minutes walk distance (6-MWD),VO2max,anaerobic threshold (AT), oxygen ventilation equivalent (EQO2,VE/VO2),carbon dioxide ventilation equivalent (EQCO2,VE/VCO2) were significantly improved (P<0.05-<0.01). Conclusion: Biventricular pacing can improve cardiopulmonary function, exercise tolerance and quality-of-life in patients with chronic heart failure.