摘要
目的:观察左心室(LV)大小和术后急性期收缩压(SBP)变化对心脏再同步化治疗(CRT)疗效的影响。方法:分别于术前及术后6个月评估21例CRT患者的心功能及超声参数。至术后6个月时,NYHA至少下降1级,左室收缩末容积(LVESV)至少降低10%的为CRT反应较好组,余为反应较差组。结果:术后6个月时,反应较好组和其基线期相比左室射血分数(LVEF)显著升高[(32±9)%vs.(45±10)%,P<0.05)]、左室舒张末容积(LVEDV)显著降低[(237±54)ml vs.(151±45)ml,P<0.05]、左室舒张末内径(LVEDD)显著降低[(68±8)mmvs.(55±6)mm,P<0.05]、左室收缩末容积(LVESV)显著降低[(165±46)ml vs.(84±31)ml,P=0.01]、NYHA的分级由术前6/8(III/IV)降至术后11/3(II/III);反应较差组和术前相比有所改善,未达到统计学意义。反应较好组术后7d SBP均显著升高(P<0.05),反应较差组下降。结论:心力衰竭患者CRT治疗反应较好与治疗前左心室较小和术后急性期SBP升高有关联性。
AIM： To study the effects of left ventricular（LV） geometry and postoperative systolic blood pressure（SBP） changes on the efficacy of cardiac resynchronization therapy（CRT）.METHODS： Twenty-one CRT recipients were included in the study.Before CRT and 6 months after,clinical and echocardigraphic evaluations were performed.At 6 months after CRT,the patients with a decrease of NYHA≥1 and a decrease of LVESV ≥10% were classified as CRT-responders and the others were classified as CRT-nonresponders.RESULTS： At baseline,no significant difference was observed in all patients except that CRT-responders had smaller LVEDD and better renal function.At 6 months after CRT,LVEF increased [（32±9）% vs.（45±10）%,P0.05],whereas NYHA（6/8,III/IV vs.11/3,II/III）,LVEDD [（68±8） mm vs.（55±6） mm,P0.05],LVEDV [（237±54） ml vs.（151±45） ml,P0.05] and LVESV [（165±46） ml vs.（84±31）,P=0.01] decreased in CRT-responders.No significant improvement was observed in CRT-nonresponders.A marked increase of SBP was found in CRT-responders.CONCLUSION： Less-altered ventricular geometry,smaller LVEDD and a prompt SBP rise just after CRT may predict a better response in CRT recipients.
出处
《心脏杂志》
CAS
2011年第6期741-743,747,共4页
Chinese Heart Journal
关键词
心脏再同步化治疗
心力衰竭
超声心动图
收缩压
cardiac resynchronization therapy
Cardiac resynchronization therapy responders
Coronary heart failure
echocardiogram
Systolic blood pressure
