左束支区域起搏对老年患者早期左室舒张功能的影响

Effect of left bundle branch area pacing on short-term left ventricular diastolic function in elderly patients

目的:比较左束支区域起搏(LBBP)和右室心尖部起搏(RVP)对房室传导阻滞的老年患者早期左室舒张功能的影响。方法:选取2018-01-2019-08期间我院因房室传导阻滞行LBBP治疗的60岁以上的患者30例(LBBP组),以我院同期行传统RVP的30例老年患者作为对照(RVP组),分析起搏术前术后患者经胸超声心动图相关参数及NYHA分级情况。结果:两组患者基线资料无统计学差异。两组术前LAD、LVEDD、IVST、PWT、LAA、LAV、LAVI、E、IVS-e、LAT-e、E/e’、TRV、LVEF、NYHA分级无统计学差异。LBBP组患者术后与术前相比,上述指标无统计学差异;RVP组术后与术前相比,LAD、LAA、LAV、LAVI、IVS-e、LAT-e、E/e’和TRV显著增加,差异有统计学意义(P<0.05),LVEDD、IVST、PWT、E、LVEF、NYHA分级无统计学差异;RVP组术后与LBBP组术后相比,LAD、LVEDD、LAA、LAV、LAVI、IVS-e、LAT-e、E/e’和TRV显著增加,差异有统计学意义(P<0.05),IVST、PWT、E、LVEF、NYHA分级无统计学差异;RVP组术后与RVP组术前及LBBP组术后相比,二尖瓣反流及三尖瓣反流缩流颈增加(P<0.05)。结论:相比传统RVP,LBBP保护老年患者早期左室舒张功能。

Objective:To investigate the effect of left bundle branch area pacing and right ventricular apex pacing on short-term left ventricular diastolic function in elderly patients with atrioventricular block.Method:There were 30 cases in left bundle branch area pacing(LBBP)group,and 30 cases in right ventricular apex pacing(RVP)group.The related parameters of transthoracic echocardiography and NYHA grading were analyzed before and after operation.Result:No significant difference was detected in baseline data between the two groups.There was no significant difference in the pre-operation LBBP group in LAD,LVEDD,IVST,PWT,LAA,LAV,LAVI,E,IVS-e,LAT-e,E/e’,TRV,LVEF and NYHA classification compared with the pre-operation RVP group,and no significant difference between the post-operation and the pre-operation LBBP group in above parameters.LAD,LAA,LAV,LAVI,IVS-e,LAT-e,E/e’and TRV were increased significantly in the postoperative RVP group compared with the preoperative group(P<0.05).No significant difference was detected in LVEDD,IVST,PWT,E,LVEF and NYHA classification between the pre-operation and the post-operation RVP group.Compared with the post-operation LBBP group,LAD,LVEDD,LAA,LAV,LAVI,IVS-e,LAT-e,E/e’and TRV were significant increased in the post-operation RVP group(P<0.05),and no statistical difference was detected in IVST,PWT,E,LVEF,NYHA classification in the post-operation RVP group.Mitral regurgitation and tricuspid regurgitation vena contracta were higher in the post-operation RVP group compared with the pre-operation RVP group and the post-operation LBBP group(P<0.05).Conclusion:LBBP is more beneficial to early left ventricular diastolic function in elderly patients than traditional RVP.