摘要
目的探讨心脏再同步治疗（CRT）对心房电生理特性的影响。方法40例接受CRT的患者，男28例，女12例，分别在CRT植入术前和术后6个月采集患者相关的临床资料，做12导联同步心电图和超声心动图，根据心电图测得最大P波时限（PMD）和最小P波时限（PMID），然后计算P波离散度（PWD）。做超声心动图测量左心房内径（LAD），左心室舒张末内径（LVEDD）和左心室射血分数（LVEF）。结果CRT植入术后6个月，PMD从术前的（126.4±10．2）ms减小到（119．7±9．5）ms，PWD从术前的（38．3±5．8）ms减小到（32．5±7．2）ms；超声心动图示LAD从术前的（45．6±6．2）mm减小到（42．7±5．5）mm，LVEDD从术前的（76．7±6．9）mm减小到（71．3±5．2）mill，LVEF从术前的0．29±0．06增加到0．36±0．07。PMD和PWD与LAD成正相关，PMD和PWD与LVEF成负相关。结论CRT可逆转心房的结构重构和电重构，有助于预防房颤的发生。
Objective To investigate the effect of cardiac resynchronization therapy on atrial electrophysiology in patients with heart failure. Methods Forty patients received CRT therapy （28 men,12 women）. Clinical data of patients are collected at baseline and six months after CRT, including 12-lead surface electrocardiography （ECG） and eehocardiography. P wave maximum duration （PMD）, P wave minimum duration （PMID） and P wave dispersion （PWD） were measured according to ECG.. Left atrial diameter （LAD） ,left ventricular end-diastolic diameter （LVEDD） and Left ventricular ejection fraction （LVEF） were measured by echocardiography. Results Six months after CRT,PMD decreased from（ 126.4±10. 2 ） ms to（ 119.7±9.5 ） ms （P〈0. 01 ） ;PWD decreased from（38.3±5.8 ） ms to （32. 5±7.2） ms（P〈0. 01 ） ; LAD reduced from （45.6± 6. 2）mm to（42. 7±5.5）ram（P〈0. 05） ; LVEDD reduced from（76. 7±6. 9）ram to（71.3±5.2） mm,LVEF in- creased from 0. 29±0.06 to 0. 36±0. 07. The decrease of PMD and PWD was positively correlated with the reduction of LAD,The decrease of PMD and PWD was negatively correlated with the LVEF. Conclusions CRT can decrease PMD and PWD in patients with heart failure along with the reduction of LAD. Therefore, CRT may reverse atrial electrical remodeling and structural remodeling, further to prevent the occurrence of atrial fibrilla- tion.
出处
《中华心律失常学杂志》
2012年第3期188-191,共4页
Chinese Journal of Cardiac Arrhythmias
基金
国家自然科学基金（308660299）,新疆维吾尔自治区自然科学基金（200821143）
关键词
心脏再同步治疗
P波离散度
心房电重构
Cardiac resynchronization therapy
P wave dispersion
Atrial electrical remodeling
