摘要
目的:观察组织多普勒指导参数优化是否可以提高心脏再同步化治疗(CRT)的疗效。方法:对23例行CRT术后左室收缩末容积改善<10%的慢性心力衰竭患者,以达到最佳疗效为目的,在超声指导下优化房室间期、室间间期,观察优化前、优化后即刻及优化后3个月患者运动耐量及超声参数的改善情况。结果:患者优化后即刻左室充盈时间(LVFT)从(365±153)ms升至(433±109)ms,二尖瓣反流由(8.62±4.75)cm2减少至(5.43±3.96)cm2;左室内各室壁收缩期达峰时间标准差(Ts-SD-12)从(47.6±18.7)ms减少至(32.2±17.8)ms,左室流出道速度时间积分(VTILVOT)由(21.6±12.0)cm/s上升至(28.1±5.2)cm/s;优化后3个月运动耐量明显提高,6min步行距离由优化前(322.49±24.36)m增加到(415.34±63.35)m,左室射血分数(LVEF)由优化前(0.26±0.09)增加到(0.37±0.15)。结论:CRT术后行组织多普勒指导下个体化参数优化,是提高CRT疗效的一种有效手段。
Objective.To observe the effect of parameter optimization in cardiac resynchronization therapy （CRT） using ultrasound cardiographs. Methods. Twenty--three heart failure patients undergoing CRT were involved. Pacing parameters were optimized by ultrasound cardiographs, the exercise tolerance and ultrasound parameters before optimization, right after optimization and 3 months after optimization were recorded and compared. Results. After optimization, left ventricular filling time （LVFT） was increased from （365±153） ms to （433±109） ms,mitral reflux （MR） was decreased from （8.62±4.75） cm^2 to （5.43±3.96） cm^2 ,standard deviation of time to regional peak systolic velocity （Ts-SD--12） was decreased from （47.6±18.7） ms to （32.2±17.8） ms, and left ventricular outflow tract velocity time integral （VTILvoT） was increased from （21.6±12.0） cm/s to （28.1±5.2） cm/s.Three months after optimization, the 6--minute walk distance was increased from （322.49±24.36） m to （415.34±63.35） re,and left ven- tricular eject fraction （LVEF） was increased from （0.26±0.09） to （0.37±0.15）. Conclusion. Pacing parameter optimization provides major hemodynamic benefits and the individualized settings using ultra-sound cardiographs are effective methods.
出处
《西北国防医学杂志》
CAS
2015年第6期351-354,共4页
Medical Journal of National Defending Forces in Northwest China
基金
陕西省社会发展科技攻关基金资助项目(2014K11-03-01-04)
关键词
慢性心力衰竭
心脏再同步治疗
超声心动图
参数优化
chronic heart failure, cardiac resynchronization therapy, ultrasound cardiograph, pacing parameter optimization
