经皮球囊二尖瓣成形术对P波离散度的影响

Effects of percutaneous balloon mitral valvuloplasty on pwave dispersion

目的评价经皮球囊二尖瓣成形术(PBMV)对P波离散度(PWD)等心电学指标的影响。方法选择31例拟行PBMV术的风湿性心脏病(简称风心病)二尖瓣狭窄患者,于术前1d、术后1～2d、术后4～6月通过12导联同步心电图、心脏超声分别测出PWD、P波最大时限(Pmax)、P波最小时限(Pmin)、左房内径(LAD)、二尖瓣口面积(MVA)、平均二尖瓣跨瓣压差(MMG)。手术过程中在球囊扩张前后通过球囊导管测出平均左房压力(MLAP)。结果PWD、Pmax、Pmin术后较术前显著减小,术后4～6月较术后1～2d也有显著减小。术后1～2dPWD、Pmax、Pmin减小量与LAD、MMG、MLAP、MVA改善程度无显著相关性(均P>0.05)。结论PWD、Pmax、Pmin的持续减小显示出PBMV术对风心病二尖瓣狭窄患者的良好效果。

Objective To evaluate the effects of percutaneons balloon mitral valvuloplasty （PBMV） on p-wave dispersion （PWD） and other electrocardiographic variables. Methods Thirty one patients with rheumatic mitral stenosis who underwent PBMV were enrolled in the study. 12-lead electrocardiogram and echocardiogram were recorded for each patient ld before PBMV and repeated at the 1-2d and 4-6m after PBMV. PWD, maximum and minimum P-wave duration （Pmax Pmin）, left atrial diameter （LAD）, mean mitral gradient （MMG）, mitral valve area （MVA） were measured respectively. During PBMV, mean left atrial pressure （MLAP） was recorded by balloon catheter before and after inflation. Results The The PWD; Pmax, Pmin after PBMV were significantly lower than those before PBMV,and those parameters also significantly decreased 4-6m after PBMV than those 1-2d after PBMV. There was no statistically significant correlation between the decrease in PWD, Pmax pmin and the improvement in LAD, MMG, MLAP, MVA at the 1-2d after PBMV （P〉0.05）. Conclusion The continuous decrease of PWD, Pmax Pmin after PBMV shows the favorable results in PBMV for patients with rheumatic mitral stenosis.