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时间:2020-05-20
《心力衰竭患者存活心肌与心脏再同步化治疗响应的关系.pdf》由会员上传分享,免费在线阅读,更多相关内容在行业资料-天天文库。
1、·326·SouthChinaJournalofCardiovascularDiseases,May2015,Vol21,No3doi:10.3969/j.issn.1007-9688.2015.03.014·论著·心力衰竭患者存活心肌与心脏再同步化治疗响应的关系张宁,孙步高,徐伟,李晓宏,徐标(南京大学医学院附属鼓楼医院心超室,南京210008)摘要:目的利用负荷三维超声心动图检测心力衰竭患者心肌的存活性,探讨心力衰竭患者存活心肌与心脏再同步化治疗(cardiacresynchronizationtherapy,CRT)响应的关系。方法心力衰竭患者28例,CRT术前检测心脏同步性
2、参数(左、右心室同步性和左心室内同步性参数),同时于术前一周行药物多巴酚丁胺负荷超声试验(DSE),CRT术后复查超声心动图检测心力衰竭患者的CRT响应。结果28例心力衰竭患者中,17例(61%)CRT术后存在响应,CRT响应组存活心肌患者比例[88%(15/17)眦18%(2/11),P<0.001]、存活心肌的节段数[(9.2±2.3)节us(3.4±1.9)节,P<0.001]与CRT无响应组比较,差异有统计学意义。对照同步性参数,两组左、右心室收缩延迟差值[(73+24)ms(46-+22)ms,P=0.005]、左心室内同步性参数左心室短轴各个节段径向应变峰值延迟最大差值
3、(RS)[(212-+81)ms(147_+62)ms,P=0.032]、四腔心切面各个节段横向应变峰值延迟最大差值(TS)[(219+84)msvs.(160~63)ms,P=0.044]比较,差异有统计学意义。结论心力衰竭患者存活心肌的存在对CRT的响应起重要作用,在分析心脏同步性的同时,心肌的存活性也是一个预测心力衰竭患者CRT响应的重要指标。关键词:心力衰竭;存活心肌;同步性;负荷超声心动图中图分类号:R541.6文献标志码:A文章编号:1007—9688(2015)03—0326—03Relationshipbetweenmyocardialviabilityinstre
4、ssechocardiographyandresponsetocardiacresynchronizationtherapyinpatientswithheartfailureZHANGNing,SUNBu-gao,XUWei,LIXiao—hong,XUBiao(DepartmentofCardiology,DrumTowerAfiliatedHospitalofMedicalCollege,NanjingUniversity,Nanjing210008,China)Abstract:ObjectivesThree—dimensionaldobutaminestressechoc
5、ardiographywasusedtoassessmyocardialviabilityinpatientswithheartfailure.Theaimofthisstudywastoevaluatetheroleofmyocardialviabilityinpredictingresponsetocardiacresynchronizationtherapy(CRT)inpatientswithheartfailure.MethodsTwenty—eightpatientswithheartfailurewereselected.Echocardiographictechni
6、queswereusedtomeasureinterventricularandintraventriculardyssynehronyhe'reCRT.Meanwhile,three—dimensionaldobutaminestressechocardiography(DSE)wasperformedtodeterminemyocardialviabilityoneweekbe~repacingimplantation.Globalfunctionalrecoveryanddetectionofviablemyocardiumwereidentifiedifleftventri
7、cularejectionfraction(EF)hadimprovedby>5%in3Dechocardiography.Follow—upechocardiographywasperformed6to12monthsafterCRT.ResponsetoCRTwasdefinedbya5-pointscaleinEFafterCRT.ResultsDuringthefollow—upperiodafterCRT,17patients(61%)wererespond
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