培哚普利对房间隔缺损介入治疗后右房室的重构作用

Effect of perindopril on right heart remodelling after transcatheter closure of atrial septal defect

目的 :评价培哚普利对房间隔缺损 (ASD)封堵术后右心大小、功能以及抗心律失常的作用。方法 :ASD均经Amplatz伞封堵后的患者共 32例 ,按性别相等 ,年龄差± 5a分成治疗组和对照组 ,2组均常规术前 1d开始予肠溶阿司匹林 2 0 0mg·d-1× 1mo ,然后 10 0mg·d-1× 5mo ,治疗组加服培哚普利 2mg ,qd× 6mo。术前、术后 6mo经胸超声心动图和ECG检查 ,计算右房和右室功能、形态的指标 ,以及观察心律失常发生情况。结果 :术后 6mo治疗组右房收缩末期上下径、左右径 ,右室舒张末期前后径、左右经、上下径、容积 ,右室收缩末期上下径及容积 ,每搏输出量 ,射血分数 ,均较对照组明显改善 (P均 <0 .0 5 ) ;治疗组阵发性房颤、房性早搏、Ⅰ度房室传导阻滞消失较对照组有显著性差异 (P均 <0 .0 5 ) ,而完全性右束支传导阻滞一般不易消失 (P >0 .0 5 )。结论 :培哚普利能明显改善ASD封堵术后患者的右心功能和形态 。

AIM:To evaluate the effects of perindopril on right cardiac size,its function and antiarrhythmias after transcatheter closure of adult secundum atrial septal defect(ASD).METHODS:Thirty two patients with secundum-type ASD after transcatheter closure by Amplatz septal occluder were divided into 2 groups: treatment group and control group according to identical sex and age±5 a.Ehocardio graphic and electrocardiographic examinations were performed before and 6 mo after closure of ASD. RESULTS: No significant difference was found between 2 groups on baseline.After 6mo with perindopril,the improvement of right ventricular end-diastolic volume,right ventricular end-diastolic diameter:anterior-posterior, left-right(right ventricular inflow through top of tricuspid leaflet) and up-down, right ventricular end-systolic diameter:up-down,right ventricualr end-systolic volume,right atrium up-down diameter and right atrium left-right diameter,right ventricular stroke volume, right ventricular ejection fraction was significantly different(P<0.05),most arrythmias diappear(P<0.05). CONCLUSION:Perindopril can improve right cardiac function,size and morphology significantly ,arrhythmias partly disappear after the transcatheter closure of ASD.