發(fā)布時(shí)間：2018-07-13 11:30

【摘要】：目的探討超聲心動(dòng)圖預(yù)測(cè)慢性充血性心力衰竭(CHF)患者心臟再同步化治療(CRT)急性反應(yīng)的價(jià)值。方法選取接受CRT的CHF患者33例,分別在CRT開啟(ON)和關(guān)閉(OFF)狀態(tài)下進(jìn)行超聲心動(dòng)圖檢查,測(cè)量左心房最大前后徑(LAD)、左心室舒張末內(nèi)徑(LVEDD)、左心室射血分?jǐn)?shù)(LVEF)、房室同步性(A-V-D)、心室間同步性(V-V-D)。采用組織多普勒技術(shù)(TDI)測(cè)量左心室收縮(Vs-T-SD)和舒張同步性(Ve-T-SD);實(shí)時(shí)三維超聲心動(dòng)圖(RT-3DE)檢測(cè)左心室收縮同步性(T16-SD%)。將CRT-ON時(shí),LVEF增加≥5%設(shè)為有反應(yīng)(CRT-R)組,5%為無反應(yīng)(CRT-NR)組。對(duì)以上數(shù)據(jù)進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果25例患者(25/33,75.76%)為CRT-R組,8例(8/33,24.24%)為CRT-NR組。CRT-R組,CRT-ON時(shí)QRSd、LVEDD、LVESD、LAD、LVEDV、LVESV、V-V-D和T16-SD%較CRT-OFF時(shí)減小,LVSV和LVEF增加(P均0.05);CRT-NR組,CRT-ON時(shí)LVEDD、LVESD和LAD較CRT-OFF時(shí)減小,LVEF增加(P均0.05)。術(shù)前CRT-R組LAD和LVEDD小于CRT-NR組,而左束支傳導(dǎo)阻滯和非缺血性心肌病患者的比例、V-V-D大于CRT-NR組(P均0.05)。V-V-D為44ms時(shí),曲線下面積為0.747,預(yù)測(cè)CRT急性反應(yīng)有效的敏感度及特異度分別為60.0%和87.5%(P0.05)。結(jié)論 LAD和LVEDD較小、室間同步性較差且合并左束支傳導(dǎo)阻滯的非缺血性心肌病的CHF患者更可能CRT急性反應(yīng)有效,V-V-D可準(zhǔn)確預(yù)測(cè)CRT急性反應(yīng)。
[Abstract]:Objective to evaluate the value of echocardiography in predicting acute cardiac resynchronization therapy (CRT) in patients with chronic congestive heart failure (CHF). Methods Thirty-three patients with CHF receiving CRT were examined by echocardiography under the condition of CRT open (on) and off (off) respectively. Left atrial maximum anteroposterior diameter (lad), left ventricular end-diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF), atrioventricular synchrony (A-V-D) and interventricular synchrony (V-V-D) were measured. Left ventricular contraction (Vs-T-SD) and diastolic synchrony (Ve-T-SD) were measured by tissue Doppler technique (TDI), and left ventricular systolic synchrony (T16-SD%) was measured by real-time three-dimensional echocardiography (RT-3DE). The increase of LVEF 鈮，

本文編號(hào)：2119208