心动过速性心肌病的临床特点及预后分析

Clinical Features and Prognosis of Tachycardia-induced Cardiomyopathy

目的分析心动过速性心肌病（TICM）患者的临床表现、诊治过程及预后。方法选取2006年1月至2011年12月在湘雅二医院心内科住院的20例心动过速性心肌病患者，比较治疗前后的心率、心脏大小和心功能变化，选取20例性别、年龄相匹配的健康人作对照。结果经过治疗后，20例患者恢复为窦性心律，平均心率由（164±17）次／分降至（81±12）次／分（P〈0．01），左室舒张末内径（LVEDD）、左房前后径（LAD）、心胸比值较治疗前显著降低，左心室射血分数明显提高（P〈0．01），但患者治疗后的LVEDD、LAD仍显著高于对照组。随访1～2年后，患者的心脏功能进一步改善。结论心动过速患者在短时间内会出现快速心律失常相关症状至发生心力衰竭，通过控制心动过速，能够显著改善患者的心力衰竭症状，但相关参数仍显著高于对照组，应坚持长期治疗和随访。

Objective To analysis the tachycardia-induced cardiomyopathy （TICM） patients with the clinical manifestations, diagnosis and treatment and prognosis. Methods In the secend XiangYa hospital Central South University clinical treatment of 20 patients with tachycardia-induced cardiomyopathy patients compared before and after treatment, heart rate, heart size and cardiac function, 20 patients with gender, age and left ventricular ejection fraction （LVEF） analyzed matched healthy control. Results After treatment, 20 patients cardioversion to sinus rhythm, with an average heart rate decreased from 164 ± 17 to 81 ± 12 times / min （P〈0.01）, left ventricular end-diastolic diameter （LVEDD）, left atrium before and after diameter （LAD）, cardiaothoracic ratio on admission was significantly decreased left ventricular ejection fraction was significantly increased （P〈0.01）, but after treatment LVEDD, LAD was still significantly higher than that in control group. Follow-up 1-2years, the patient＇s cardiac function is further improved. Conclusion Tachycardia patients in a short period of time appears tachyarrhythmia related to symptoms of heart failure, by controlling tachycardia, can significantly improve the patient＇s symptoms of heart failure, but the data is still significantly higher than that in control group, should adhere to the long-term treatment and follow-up.