左室功能和结构改变与心脏起搏器起搏比例的关系

The Relation between Functional or Structural Remodeling of Left Ventricle Following Pacemaker Implantation and the Ratio of Heart Beats by Pacemaker

目的分析心脏起搏器植入后远期左室收缩功能和结构改变的特点厦其与起搏比例的关系。方法共入选20例病人，其中植入VVI起搏器10例．DDD起搏器10例。采用双探头门控单电子发射计算机断层摄影系统测定病人植入起搏器3年～4年后自身心律状态时左室射血分数（LVEF）、左室舒张末容积（EDV）、左室收缩末客积（ESV）厦每搏量（SV）。结果起搏器植入后远期EDV、ESV呈增高趋势，LVEF植入前为（61．5±14．2）％，植入后为（53．4±13．9）％呈降趋势，且植入后远期LVEF在≥50％与〈50两亚组均呈下降趋势。结论起搏器植入后远期。可发生左室功能和结构重塑，表现为LVEF增高或降低和EDV增大或减小。EDV增大、LVEF降低与起搏心搏数呈正相关。

Objective To analyse the characters of systolic functional and structural remodeling of left ventricle long - term following pacemaker implantation and its relation to the ratio of heart beats by pacemaker. Methods The left ventrieular ejection fraction （LVEF）, end -diastolic volume （EDV）, end- systolic volume （ESV） of the left ventricle in autologous rhythm were collected by the gated single photon emission computed tomography before implantation of pacemaker and at follow- up in 20 patients （pts）. Among them, 10 pts were implanted with VVI pacemaker, and 10 pts were implanted with DDD pacemaker. Results In autologous rhythm, the LVEF increased in 1 patient and decreased in 13 pts. EDV increased in 9 pts and decreased in 3 pts. The ratio of autotogous heart beats/the beats by pacemaker in 24 hrs for pts with enlargement of EDV and for pts without enlargement of EDV was 0.397 ± 0. 205 and 0. 869 ± 0. 127, respectively （P 〈 0.05）. Conclusion The functional remodeling and structural remodeling of left ventricle appeared late following the implantation of the pacemaker in most pts. The increase of EDV of the left ventricle and decrease of LVEF was related to the heart beats by pacemaker.