心脏再同步化治疗后右心室收缩及舒张功能的早期变化.pdfVIP

中国循环杂志 2013 年 4 月 第 28 卷 第 2 期（总第 180 期）Chinese Circulation Journal，April，2013，Vol. 28 No.2（Serial No.180） 129 ·临床研究· 心脏再同步化治疗后右心室收缩及舒张功能的早期变化 * 孙欣，江勇，焦盼晴，张红菊，徐楠，吴伟春，兰亭玉，樊晓寒，王浩 摘要 目的：应用超声评价充血性心力衰竭（心衰 ）患者心脏再同步化治疗（CRT）后右心室收缩及舒张功能的早期变化。 方法：因慢性充血性心衰行 CRT 治疗的患者 44 例，在术前、术后 1 周及术后 6 个月行超声心动图检查。测量参数包括： 右心室面积变化率，三尖瓣环收缩期位移，右心室游离壁三尖瓣环收缩期运动速度（Vsr）、右心室侧壁三尖瓣环运动速度 E’ 峰的比值（RV-E/E’）、右心室心肌做功指数等。以 CRT 术后 6 个月左心室收缩末容积减小≥ 15% 为有应答的标准分为无 应答组（n =15）与有应答组（n =29），分别比较两组 CRT 术前后各参数的差异。 结果：无应答组与有应答组相比，术前的右心室面积变化率、三尖瓣环收缩期位移及 Vsr 低，RV-E/E’高，差异均有 统计学意义（P 均＜ 0.05）。术后 1 周内，两组患者的右心室面积变化率、右心室游离壁三尖瓣环收缩期位移、Vsr、RV-E/E’ 及右心室心肌做功指数均有改善，与术前相比差异均有统计学意义（P 均＜ 0.05）。 结论：CRT 术后无论有应答组或无应答组，右心室的收缩功能及舒张功能均可得到即刻的改善。 关键词 心脏再同步化治疗；右心室功能；超声心动图 The Early Effect of Cardiac Resynchronization Therapy on Right Ventricular Systolic and Diastolic Functions in Patients With Congestive Heart Failure SUN Xin, JIANG Yong, JIAO Pan-qing, ZHANG Hong-ju, XU Nan, WU Wei-chun, LAN Ting-yu, FAN Xiao-han, WANG Hao. Department of Echocardiography, Cardiovascular Institute and Fu Wai Hospital, CAMS and PUMC, Beijing (100037), China Corresponding Author: WANG Hao, E-mail: hal6112@ Abstract Objective: To evaluate the early effect of cardiac resynchronization therapy (CRT) on right ventricular (RV) systolic and diastolic functions in patients with congestive heart failure (CHF) by echocardiography and tissue Doppler imaging. Methods: There were 44 consecutive CHF patients who received CRT treatment enrolled in our study. The patients underwent echo examination before CRT, and at 1 week, 6 months after CRT respectively. CRT response was defined as LV end-systolic volume decreasing ≥15% at 6 months after CRT. The patients were divided into 2 groups as Non-response group