多普勒Tei指数在心脏再同步化治疗疗效评价中的作用研究

Doppler Tei index in evaluation of efficacy of cardiac resynchronization therapy

目的研究左右心室Tei指数在心脏再同步化治疗(CRT)疗效评价中的作用。方法选取36例接受CRT手术的慢性心力衰竭患者。随访超声心动图参数,根据术前和术后6个月随访的左心室收缩末期容积缩小百分比将患者分为有反应组和无反应组,分析两组的左右心室Tei指数变化情况。结果有反应组20例,无反应组16例。有反应组左心室Tei指数在术后1周及6个月后较术前差异有统计学意义(均P<0.01)。而无反应组中左心室Tei指数术后较术前差异无统计学意义(P>0.05)。有反应组右心室Tei指数在术后1周及术后6个月较术前差异有统计学意义(均P<0.01),而无反应组术后无明显改善(P>0.05)。结论 CRT术前有反应组患者左心室Tei指数较高而术后呈现显著而持续的改善,可将Tei指数作为对CRT有反应的预测因子。CRT对左心室功能的改善间接导致了右心功能的改善。

Objective To assess the application of Doppler Tel index in evaluation of the efficacy of cardiac resynchro- nization therapy （CRT） in patients with chronic cardiac failure. Methods Thirty six patients with heart failure who underwent CRT were enrolled in the study. The patients were followed up for 6 months, if the left ventricular end-systolic volume （LVESV） was de- creased than the baseline value by 〉 10%, the patient was classified as responder. Doppler echocardiography was performed before and 1 week, 6 months after CRT; the changes of LV and RV Tel index were analyzed in responders and non-responders. Results There were 20 responders and 16 non-responders for CRT. The LV and RV Tel indexes in responders were improved significantly at 1 week and 6-month after CRT, compared with the baseline （P〈0.01）; while there were no improvement in LV and RV Tel index in non-respenders. Conclusion Patients with higher LV Tel index at baseline may achieve a sustained improvement after CRT, suggesting that the baseline Tel index can be used as a predictor for CRT response in patients with chronic heart fail- ure.