摘要
目的分析射频消融术(radiofrequency catheter ablation,RFCA)对不同起源频发室性期前收缩患者左心房功能、结构及血浆脑钠肽(brain natriuretic peptide,BNP)浓度的影响。方法收集2016年1月至2019年12月宣城市中心医院与南京市第一医院93例行RFCA治疗的频发室性期前收缩患者的临床资料,依据室性期前收缩的不同起源,分为左心室组(30例)和右心室组(63例),另选取40例同期体检健康人员为对照组。检测3组研究对象左心房功能和结构,并比较左心室组与右心室组患者手术前后血浆BNP浓度和左心房功能及结构的变化情况。结果相比对照组,左心室组与右心室组患者的左心室射血分数(left ventricular ejection fraction,LVEF)、左心房射血分数(left atrial ejection fraction,LAEF)及左心室每搏排血量(left ventricular stroke volume,LVSV)均明显下降,左心室内径(left ventricular diameter,LVD)、左心房内径(left atrial diameter,LAD)、左心室后壁厚度(left ventricular posterior wall diameter,LVPWD)、左心室舒张末期内径(left ventricular end diastolic diameter,LVEDD)、左心室收缩末期内径(left ventricular end systolic diameter,LVESD)、左心房收缩期左心房应变率(left atrial strain rate during left atrial systole,LASRa)均明显升高,差异有统计学意义(P<0.05)。右心室组患者术后4周LAEF明显高于左心室组,术后1周和术后4周LAD均明显低于左心室组,术后1周和术后4周左心房应变率(left atrial strain rate,LASR)、LASRa和左心室收缩期左心房应变率(left atrial strain rate during left ventricular systole,LASRs)较左心室组明显改善,差异有统计学意义(P<0.05)。相比对照组,左心室组与右心室组患者术前血浆BNP浓度均明显升高,差异有统计学意义(P<0.05);左心室组与右心室组患者术后4周血浆BNP浓度均显著低于术前,差异有统计学意义(P<0.05);右心室组患者术后4周血浆BNP浓度均明显低于左心室组,差异有统计学意义(P<0.05)。结论不同起源的频发室性期前收缩患者出现血浆BNP浓度升高、左心房功能和结构受损的情况,右心室起源的患者经RFCA术后血浆BNP浓度、左心房功能及结构改善均明显优于左心室起源的患者。
Objectives To analyze the effect of radiofrequency catheter ablation(RFCA)on left atrial function,structure and plasma concentration of brain natriuretic peptide(BNP)in patients with frequent premature ventricularcontractions of different origins.Methods Totally 93 patients with frequent premature ventricular contractions treatedby RFCA were selected in Xuancheng Central Hospital and Nanjing First Hospital from January 2016 to December 2019.According to the different origins of premature ventricular contractions,93 patients were divided into left ventriculargroup(n=30)and right ventricular group(n=63),and 40 healthy persons in the same period were selected as controlgroup.The function and structure of left atrium in the three groups were measured,and the changes of plasma concen-tration of BNP and left atrium function and structure before and after operation were compared.Results Compared with control group,left ventricular ejection fraction(LVEF),left atrial ejection fraction(LAEF)and left ventricularstroke volume(LVSV)in left ventricular group and right ventricular group significantly decreased;while left ventriculardiameter(LVD),left atrial diameter(LAD),left ventricular posterior wall diameter(LVPWD),left ventricular enddiastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD),left atrial strain rate during left atrialsystole(LASRa)significantly increased(P<0.05).LAEF of right ventricular group was significantly higher than that ofleft ventricular group at 4 weeks postoperatively,LAD of right ventricular group at 1 week and 4 weeks postoperativelywere significantly lower than those of left ventricular group,and the left atrial strain rate(LASR),LASRa and left atrialstrain rate during left ventricular systole(LASRs)of right ventricular group significantly improved compared with thoseof left ventricular group(P<0.05).Compared with control group,plasma concentration of BNP in left and right ventriculargroups were significantly higher(P<0.05)before operation.Plasma concentrations of BNP in left and right ventriculargroups at 4 weeks after operation were significantly lower than those before operation(P<0.05).Plasma concentrationof BNP in right ventricular group was significantly lower than that in left ventricular group at 4 weeks after operation(P<0.05).Conclusions Plasma concentration of BNP in patients with frequent ventricular premature contractions ofdifferent origins increases,and the left atrium function and structure are damaged.Plasma concentration of BNP,theleft atrium function and structure in patients with right ventricular origin are significantly better than those in patientswith left ventricular origin patients after RFCA.
作者
赵伟
王建平
ZHAO Wei;WANG Jian-ping(Department of Cardiology,Central Hospital of Xuancheng City,Xuancheng,Jiangsu 242000,China;De-partment of Cardiology,Nanjing First Hospital,Nanjing 210000,China)
出处
《岭南心血管病杂志》
CAS
2021年第1期27-31,共5页
South China Journal of Cardiovascular Diseases
关键词
射频消融术
室性期前收缩
脑钠肽
左心房功能
心脏结构
radiofrequency ablation
premature ventricular contractions
brain natriuretic peptide
left atrial function
heart structure
