超声心动图对心脏再同步化治疗心力衰竭患者疗效的评价

Effects evaluation of cardiac resynchronization therapy on cardiac function in patients with chronic heart failure by echocardiography

目的应用超声心动图来评价心脏再同步化治疗(CRT)心力衰竭患者的疗效。方法 16例慢性心力衰竭患者行CRT植入,于术后1周、3个月、6个月对AV和VV间期进行优化,观察术前及术后1周、3个月、6个月左心室舒张末、收缩末的直径(LVDD、LVDS)及左室舒张、收缩末期容积(LVEDV、LVESV)和左室射血分数(LVEF),及心脏同步化指标的变化。结果与术前比较,术后3个月、6个月心功能均得到改善,6 min步行距离增加,LVEF增加,LVDD、LVDS、LVEDV和LVESV缩小,心脏同步化指标得到改善。结论在超声指导下对AV、VV间期进行优化后心脏再同步化治疗可改善双心室的同步性和心脏功能。

Objective To observe the effects of cardiac resynchronization therapy（CRT） on the cardiac function in patients with chronic heart failure by echocardiography. Methods Sixteen patients with chronic heart failure were assigned to CRT. The AV and VV delay were optimized by echocardiography at one week,three months and six months after operation,respectively. The left ventricular end-diastolic dimension （LVDD） ,end-contractive dimension（LVDS）, the left ventricular end-diastolic volume （LVEDV）and left ventricular end-systolic volume （LVESV） ,left ventricular ejection fraction （LVEF） and the distance walked in six minutes were measured and compared before CRT operation,at one week,three months and six months after CRT operation. The changes of synchrony cardiac index were also observed. Results Compared with pre-CRT,the patients experienced an improvement in the NYHA functional class and synchrony cardiac index, with the distance walked in six minutes elongated,the LVEF raised,the LVDD,LVDS,LVEDV and LVESV decreased. Conclusions CRT results in significant clinical improvement in patients＇ biventricular mechanical synchrony and cardiac function after AV, VV delay optimizing guided by echocardiography.