VVI起搏器工作停止后心房扩大和房室瓣反流的逆转

Changes of Atrial Size and Valvular Regurgitation after Stopping of VVI Pacemaker

为探讨VVI起搏器工作停止后的心房结构和房室瓣反流情况，我们观察13例安植VVI起搏器后因多种原因起搏器工作停止又恢复正常窦性心律的心肌梗塞患者（A组）。对照组（B组）为年龄、病因、起搏器安植时程基本与A组匹配的心肌梗塞患者15例。用二维超声心动图测定左心房上下径，左右心房前后径，中侧径和容量。彩色多普勒异常反流束面积法测房室瓣返流面积，多普勒超声测主动脉瓣下速度时间积分（VTI）。结果A组起搏器停止工作半年后心房内径和房室瓣反流程度明显减小，VTI明显增大，B组在起搏器继续工作半年后，心房内径和返流面积略增大，VTI略减小，提示VVI右心室起搏可对心房结构和瓣膜产生不利作用。而起搏器工作停止后恢复窦性心律一段时间心房扩大和房室瓣反流可逆转，并可改善心输出量。

In order to explore the change of atrial size and AV valvular regurgitation after stopping of VVI pacemaker, 13 patients (A group) with normal sinus rhythm after stopping of pacemaker were observed for six months, The compared group (B group) consisted of 15 patients with pacemaker dependent. Echocardiographic indexes included: Left atrial anteroposterior, left and right atrial mediolaterral,supreinferior dimension and volume,tricuspid and mitral valvular regurgitative area (A) measured by color Doppler,aortic flow velocity integral (VTI) measured by Deppler. The result showed:the atrial size and A were significantly decrease in A group after stopping of pacemaker for six months. No significant changes in A group. The conclusion: VVI pacemaker can induce atrial enlargement and AV valvular regurgitation. After stopping of pacemaker and restoration of sinus rhythm for six months atrial size and AV valvular regurgitation can decrease associated with increase of left ventricular stroke volume.