心脏再同步化治疗术后短期右心室功能改变情况

Early effect of cardiac resynchronization therapy on right heart functions in patients with heart failure

目的 探讨慢性心力衰竭患者心脏再同步化治疗（CRT）术后短期右心室功能改变情况.方法 选择2005年1月至2013年11月于首都医科大学附属北京安贞医院行介入CRT的慢性心力衰竭患者43例,分别于术前和术后1周超声心动图测量并比较右心室内径、右心房面积、三尖瓣环平面收缩期位移（TAPSE）、三尖瓣反流面积和肺动脉收缩压（SPAP）的变化.结果 43例患者均顺利安装了三腔起搏器,CRT术后1周右心房面积和三尖瓣反流面积较术前明显减小[（17 ±6）cm^2比（18±7）cm^2,（2.4±1.9） cm^2比（3.2±2.1） cm^2],差异有统计学意义（P＜0.05）;TAPSE和SPAP较术前明显改善[（12.9±2.8）mm比（11.6±2.6）mm,（32±10）mmHg（1 mmHg=0.133 kPa）比（37±15） mmHg],差异有统计学意义（P＜0.01）.结论 CRT能够在术后早期改善心力衰竭患者右心室功能.

Objective To evaluate the early effect of cardiac resynchronization therapy （CRT）on right heart functions in patients with heart failure （HF）.Methods Forty three patients with HF undergoing CRT from Juanary 2005 to November 2013were enrolled.Before and 1 week after CRT,the right ventricular diameter （RVD）,right atrial area （RAA）,tricuspid annular plane systolic excursion （TAPSE）,area of tricuspid regurgitation （TRA） and systolic pulmonary artery pressure （SPAP） were measured by echocardiography to analyze the right heart function.Results The triple chamber pacemakers were successfully implanted in all the patients.After CRT,RAA and TRA were significantly decreased compared with those before CRT [（17 ± 6）cm^2 vs （18 ± 7） cm^2,（2.4±1.9） cm^2 vs （3.2±2.1） cm^2] （P〈0.05）;theTAPSE and SPAPwere improved[（12.9± 2.8） mmvs （11.6±2.6） mm,（32±10） mmHg vs （37±15） mmHg]（P〈0.01）.Conclusion The right heart function can be improved in an early stage after CRT in HF patients.