无创血流动力学检测评价特发性室性期前收缩患者经导管射频消融术前后心功能变化的临床研究

Recovery of cardiac function in patients with frequent premature ventricular contraction after radiofrequcency catheter ablation by noninvasive hemodynamic detection technique

目的联合心脏超声及无创血流动力学检测技术探讨频发室性期前收缩(PVC)患者经导管射频消融术(RFCA)前后心功能变化。方法选取48例特发性频发PVC患者为试验组,PVC总数(16 391.03±10 873.01)个/24 h,另外随机选取55例健康查体者为对照组,分别行心脏超声及无创血流动力学检测。同时选试验组中25例患者行RFCA治疗,于术后3 d行无创血流动力学检测。分别比较两组心脏超声及无创血流动力学检测结果,及RFCA前、后3 d无创血流动力学检测结果。结果所有超声结果均无统计学差异。比较PVC组与对照组的无创血流动力学检测结果,PVC组中心缩力指数(HI)、心搏指数(SI)、心脏指数(CI)、室缩波波幅(C)较对照组降低,差异具有统计学意义(P<0.05),而房缩波波幅(WA)、室舒波波幅(O)、左室顺应性指数(WA/C)、舒张功能指数(O/C)较对照组升高,差异具有统计学意义(P<0.01);比较RFCA术前与术后3 d患者无创血流动力学检测结果,术后3 d患者HI、SI、CI、C水平显著升高(P<0.01),而WA、O、WA/C、O/C较术前降低,差异具有统计学意义。结论特发性PVC患者在病程早期其心功能可能已受损,经RFCA可逆转或防止患者因频发PVC而损及心功能。

Objective To explore the change in cardiac function in patients with idiopathic frequent premature ventrieular contraction（PVC） after radiofrequency catheter ablation（RFCA） and drug control by ultrasound Doppler and noninvasive hemodynamic detection technique. Methods Forty-eight patients with idiopathic frequent PVC were selected as the test group with a total of（ 16 391.03 ± 10 873. 01 ） beats per day. Another 55 healthy subjects were selected as the control group. Heart ultrasound Doppler and noninvasive hemodynamic detection technique were used in the two groups. Twenty-five patients were selected from the PVC group to receive RFCA, while noninvasive hemodynamic detection technique was adopted 3 days after operation. Results by ultrasound Doppler and noninvasive hemodynanfic detection technique were compared between the two groups before and after operation. Results There was no significant difference in left ventrieular ejection fraction （ LVEF ） , left ventricular end-diastolic dimension （ LVEDD ）, left ventricular end-systolic dimension （LVESD） ,left atrial diameter（LA） and the ratios of the peak mitral flow velocity in early diastole （E） to the peak atrial kick velocity （A） between the two groups. HI, SI, CI and C in PVC group were significantly lower than those in control group（ P 〈0. 01 ）, but WA, O, WA/C and O/C were significantly higher than those in control group（ P 〈 0. 01 ）. HI, SI,CI and C obviously increased 3 days after operation （ P 〈0. 01 ） , but WA, O, WA/C and O/C significantly decreased （ P 〈 0.01 ）. Conclusion The cardiac functio of idiopathic PVC patients in the early stage may have been damaged, and RECA can reverse or delay the damaged cardiac function due to frequent PVC.