摘要
目的探讨双腔起搏器不同房室延迟（AV间期）起搏对单纯舒张功能不良患者左心房功能的影响。方法选择植入双腔起搏器的患者76例，分为单纯舒张功能不良组（38例）和心功能正常组（38例），应用超声心动图及应变率成像测算在不同AV间期时的心排出量（CO）、左心房射血分数（LAEF）；收缩期、舒张早期和舒张晚期的左心房心肌平均峰值应变率（SR—S、SR—e和SR—a）。结果单纯舒张功能不良组：Q）AV间期自80ms开始增至200ms时，SR—a、LAEF和CO随AV间期的延长相应增大，在AV间期200111S时达到最大，达峰值后逐渐下降，SR．a、LAEF和CO在AV间期〈150ms及〉200ms时较AV间期150～200ms时降低（P〈0．05）；（2）AV间期为80ms时SR—S较AV间期为200ms时增加明显（P〈0．05）。心功能正常组：①随着AV间期变化，评价左心房功能的各指标无显著变化（P〉0．05）；②CO在AV间期为150ms时达到最大，在AV间期〈150ms及〉200ms时较AV间期为150—200ms时降低（P〈0．05）。结论双腔起搏器不同AV间期可影响单纯舒张功能不良患者左心房的收缩功能，适当延长AV间期在生理上更有利于左心房功能的改善。
Objective To investigate the effect of different AV delays on left atrial function in DDD pacemaker implanted patients with diastolic dysfunction. Methods Seventy-six patients with DDD pacemaker were enrolled into the study. Patients were divided into two groups：one with normal cardiac function and the other with diastolic dysfhnction. Left atrial ejection fraction （LAEF）and cardiac output （CO） were measured using eehocardiography. Mean systolic peak strain rate（SR-s） , mean early diastolic peak strain rate（SR-e） and mean late diastolic peak strain rate （SR-a） were measured using real-time triplane strain rate imaging. The re- sults were compared between different AV delays. Results The group of diastolic dysfimction ： ~When AV de- lay increased from 80 to 200 ms, LAEF , SR-a and CO gradually increased. When AV delay increased to 200 ms, LAEF, CO, SR-a were reached to the highest level. Further increase in AV delay to 250 ms resulted in decreased SR-a,LAEF and CO. （2）Compared with 200 ms AV delay, SR-s increased significantly at 80 ms AV delay（P〈0. 05）. While in the group of normal cardiac function,insignificant changes in LAEF,SR-s,SR-e and SR-a were detected by setting AV delay. Conclusion Setting of AV delay has significant effect on the left atrial function in patients with diastolic dysfunction, and moderate prolongation of AV delay has a favorable effect.
出处
《中华心律失常学杂志》
2012年第3期211-213,共3页
Chinese Journal of Cardiac Arrhythmias
关键词
双腔起搏器
房室延迟
左心房功能
应变率
Dual-chamber pacemaker
Atrioventricular delay
Left atrial function
Strain rate
