超声指导下心脏再同步化治疗慢性心力衰竭12例

目的观察超声指导下心脏再同步化治疗(CRT)对慢性心力衰竭(简称心衰)患者心功能的影响。方法 12例扩张型心肌病慢性心衰患者行CRT治疗,其中2例永久性心房颤动患者同时行房室结消融术。于术后1周、3个月、6个月对AV和VV间期进行优化,观察术前及术后3个月、6个月的NYHA心功能分级、6min步行距离、QRS波时限、左室射血分数(LVEF)、左室舒张末内径(LVEDD)、二尖瓣返流量(MRA)及心脏同步化指标的变化。结果与术前比较,术后3个月、6个月心功能均得到改善,6min步行距离增加,LVEF增加,LVEDD缩小,MRA减少,心脏同步化指标得到改善。结论在超声指导下对AV、VV间期进行优化后心脏再同步化治疗可改善双心室的同步性和心脏功能。

Effects of cardiac resynchronization therapy on cardiac function in patients with chronic heart failure guided by echocardiography

Objective To observe the effects of cardiac resynchronization therapy （CRT） optimized by eehoeardiography on the cardiac function in patients with chronic heart failure. Methods Twelve patients with dilated eardiomyopathy （DCM） received CRT, AVN were ablated by radiafrequency in 2 patients with permanent atrial fibrillation. The AV and VV delay were optimized by eehoeardiography at 1 week ,3 months and 6 months after operation. The NYHA functional class ,6 minutes walk distance, QRS duration, left ventricular ejection（ LVEF）, left veutricular end-diastolic dimension, mitral regurgitation area（MRA） and the synchrony index were measured before and 1 week ,3 months and 6 months after implantation. Results Compared with pre-CRT, the NYHA functional class,the 6 minutes walk distance and the LVEF improved,the LVEDD and the MRA decreased,all the synchrony index increased significantly too. Conclusion CRT can improve the bi-ventricular mechanical synchrony and cardiac function after AV, VV delay optimization guided by echocardiography. Chinese Journal of Cardiac Pacing and Electrophysiology,2010,24 （ 4 ） ：310 - 312 ]