双心室起搏对慢性心力衰竭患者心肺功能的影响

Effects of biventricular pacing on cardiopulmonary function in patients with congestive heart failure.

目的 观察双心室起搏对慢性心力衰竭患者心肺功能的影响。方法 慢性心力衰竭伴室内传导阻滞患者 9例 ,全部植入三腔双心室起搏器 ,比较双心室起搏前后患者超声心动图、心肺功能的变化。结果 双心室同步起搏后 ,患者左室射血分数由术前 (2 1.6± 6 .7) %增加到 (2 7.3± 5 .2 ) % (术后 3月 ,P <0 .0 5 )、(2 9.5± 5 .4 ) % (术后 6月 ,P <0 .0 5 ) ,6分钟步行距离由术前 (32 0± 97)m增加到 (384± 10 3)m(术后 3月 ,P <0 .0 1)、(4 13± 110 )m(术后 6月 ,P <0 .0 1) ,峰值氧耗量、摄氧效率斜率及每分通气量 /每分二氧化碳产生量斜率较术前均有显著增加。生活质量评分分别改善 30 % (术后 3月 ,P <0 .0 1)、2 8% (术后 6月 ,P <0 .0 1)。结论 双心室起搏能有效改善慢性心衰患者心肺功能 ,增加运动能量 。

Objective To observe the clinical effects of biventricular Pacing in Patients with congestive heart failure. Methods The investigation included 9 patients, with chronic heart failure and left bundle branch block. All of them received biventricular synchronous pacing and the coronary sinus lead was inserted into the branch of coronary sinus to pace left ventricle. Results After biventricular synchronous pacing, the echocardiography parameters (including Left ventricular ejection fraction, left ventricular end-diastolic diameter, left ventricular end-systolic diameter, left ventricular filling time and the degree of mitral regurgitation) and cardiopulmonary parcmeters(including maximal oxygen consumption, Distance walked in 6 minutes, oxygen consumption at anaerobic threshold, respiratory efficiency and oxygen uptake efficiency slope) were significantly improved. The quality of life score improved by 30% (3 months later, P< 0.01), 28% (6 months later,P< 0.01). Conclusion Biventricular pacing can improve cardiopulmonary function, exercise tolerance and quality-of-life in patients with chronic heart failure and intraventricular conduction delay.