双心室起搏逆转心脏结构重塑的临床观察 |
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引用本文: | 许春萱,陈林,陈诗泉,颜光烈,陈德伟,邓玉莲,胡锡衷. 双心室起搏逆转心脏结构重塑的临床观察[J]. 中国心脏起搏与心电生理杂志, 2002, 16(4): 262-264 |
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作者姓名: | 许春萱 陈林 陈诗泉 颜光烈 陈德伟 邓玉莲 胡锡衷 |
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作者单位: | 福建省心血管病研究所心内科,福建福州,350001 |
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摘 要: | 观察双心室同步起搏治疗慢性充血性心力衰竭 (简称心衰 )逆转心脏结构重塑的中远期疗效并探讨其可能机制。4例扩张性心肌病中晚期患者 ,心功能NYHA分级Ⅲ级 2例、Ⅳ级 2例 ,均伴有心室内阻滞。其中 3例置入三腔双心室起搏器、1例为四腔起搏。术后对心功能、二维超声心动图、动态心电图、心脏远达正侧位片等进行了 12~ 2 0个月的随访。所有双心室起搏器均一次性安置成功。随访资料显示 4例患者各房室内径 ,心胸比率缩小 ;心脏搏出量、左室射血分数等显著提高 ;二尖瓣返流、QRS波时限减少 ,NYHA分级提高到Ⅰ~Ⅱ级 ,6min步行距离明显增加。心脏结构重塑时间发生在术后 6个月内 ,以后结构趋于稳定。 4例中 1例猝死 ,无一例因严重心衰而住院或死亡。结论 :双心室起搏能逆转慢性心衰患者的心脏结构重塑 ,明显改善心功能 ,提高生活质量。
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关 键 词: | 双心室起搏 慢性心力衰竭 心脏结构重塑 |
文章编号: | 1007-2659(2002)04-0262-03 |
修稿时间: | 2002-06-24 |
The Clinical Study of Biventricular Pacing Reversing Cardiac Remodeling in Heart Failure. |
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Abstract: | To observe the effect of reverse cardiac structure remodeling in patients with chronic congestive heart failure(CHF) by biventricular pacing and its underlying mechanisms,four patients with NYHA class Ⅲ to Ⅳ heart failure,left ventricle ejection fraction(LVEF)≤0.35,and electrocardiographic QRS wave complex duration>140 ms were recruited.All patients received biventricular pacing(3 case in right atrial and biventricular pacing and 1 case in biatrial and biventricular pacing)and the effects of this therapy were assessed serially up to 12~20 months after pacing by 2D UCG,Holter,NYHA class and 6 minute hall walk distance etc.Compared with the corresponding values at baseline,there was significant improvement of LVEF,cardiac output,and 6 minute hall walk distance and decreasing in the diameter of atria and ventricle after pacing for 12~20 months.The reducing in mitral regurgitation,QRS duration and NYHA class were also observed.Conclusion:Biventricular pacing reverses heart structure remodeling and improves cardiac function in patients with CHF. |
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Keywords: | Bivetricular pacing Congestive heart failure Cardiac structure remodeling |
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