摘要
观察双室同步起搏对扩张性心肌病并心力衰竭 (简称心衰 )患者心功能及心率变异性 (HRV)的影响。选择1 5例扩张性心肌病并顽固心衰患者 ,置入双室起搏器 ,观察心功能、HRV及血浆丙二醛、一氧化氮、内皮素 1、血管紧张素 Ⅱ的变化。结果 :心功能NYHA分级从术前 3.32± 0 .31级提高为 2 .1 8± 0 .33级 ,左室射血分数由 0 .2 9± 0 .0 3增至 0 .36± 0 .0 3(P <0 .0 5 ) ;2 4h正常RR间期均值标准差、相邻RR间期差值均方根、相邻RR间期差值 >5 0ms占正常RR间期数的百分比、总功率、低频及高频波段功率分别由 73± 8.1ms、4 1± 8.0ms2 、5 .3%± 1 .5 %、1 0 2 4± 4 1 3ms2 、1 1 5± 35ms2 及 4 8± 1 5ms2 增至 1 0 7± 1 3ms、70± 1 1ms2 、1 1 .3%± 3.4 %、1 92 1± 4 84ms2 、1 94± 35ms2 及 91± 2 9ms2 (P均 <0 .0 1 ) ;血浆丙二醛、内皮素 1分别由 4 31± 37nmol/L、83.1± 2 1ng/L降至 32 3± 2 9nmol/L、6 7.3± 1 6ng/L ,一氧化氮由 38.1± 7.6 μmol/L增至 5 1 .3± 9.2 μmol/L(P均 <0 .0 1 ) ,血管紧张素 Ⅱ无变化 (P >0 .0 5 )。结论 :同步起搏改善扩张性心肌病心衰患者心功能及HRV。
To assess the effect of resynchronization therapy with biventricular pacing on cardiac function and heart rate variability(HRV) in heart failure patients with idiopathic dilated cardiomyopathy(IDCM),Fifteen congestive heart failure patients with IDCM were received resynchronization therapy with biventricular. Prior to and following pacing patients underwent NYHA class evaluation, left ventricular ejection fraction were measured by Echo Doppler, time and frequency domain HRV parameters were calculated from 24 h digital holter monitoring, and plasma malondialdehyde, nitric oxide, endothelin 1, angiotensin Ⅱ were measured also. Results:Biventricular pacing improved NYHA functional class(3.32±0.31 vs 2.18±0.33), increased LVEF(0.29±0.03 vs 0.36±0.03, P<0.05); increased SDNN, rMSSD, pNN 50 , Total Power, LFP and HFP (73±8.1ms,41±8.0 ms 2,5.3%±1.5%,1 024±413 ms 2,115±35 ms 2,48±15 ms 2 vs 107±13 ms,70±11 ms 2,11.3%±3.4%,1 921±484 ms 2,194±35 ms 2,91±29 ms 2, respectively, all P<0.01); decreased plasma malondialdehyde, endothelin 1, increased nitric oxid(431±37 nmol/L,83.1±21 ng/L,38.1±7.6 μmol/L vs 323±29 nmol/L,67.3±16ng/L,51.3±9.2μmol/L,respectively,all P<0.01) and not decreased angiotensin Ⅱ level (P>0.05). Conclusion:Resynchronization therapy with biventricular pacing improve cardiac function and HRV in congestive heart failure patients with IDCM.
出处
《中国心脏起搏与心电生理杂志》
2004年第3期184-186,共3页
Chinese Journal of Cardiac Pacing and Electrophysiology
关键词
心血管病学
双室起搏
扩张性心肌病
心力衰竭
充血性
心功能
心率变异性
Cardiology Biventricular pacing Idiopathic dilated cardiomyopathy Congestive heart failure Cardiac function Heart Rate Variability
