バイブントリキュラーペースは,エジェクション分子が低下した患者の右心室ペースと比較して,交感活性を低下させる
M H Hamdan1, J D Zagrodzky, J A Joglar
1University of Texas Southwestern Medical Center and Dallas Veterans Affairs Medical Center, Dallas, TX 75216, USA. Hamdan@ryburn.swmed.edu
Circulation
|August 30, 2000
まとめ
左心室 (LV) ペースは,左心室 (LV) 機能不全患者の右心室 (RV) ペースと比較して,血圧を改善し,交感神経活動 (SNA) を減少させます. ビビントリキュラー (BV) ペースアップも利点を示しており,LVベースのペースアップが血液動力学および自律的調節に優れていることを示唆しています.
科学分野:
- 心臓病学 心臓病学
- 自律神経系の研究
- 医療機器技術 医療機器技術について
背景:
- 右心室 (RV),左心室 (LV),双心室 (BV) のペースの血液動力学的効果に関する比較研究は限られている.
- 異なる心臓ペースモードの間の自律神経系の変化は,ほとんど知られていない.
研究 の 目的:
- RV,LV,BVペースの血液動力学および自律的効果を調査する.
- BVペースは,同位体のペースと比較して,血動力学を改善し,交感神経活動 (SNA) を低下させるという仮説を検証する.
主な方法:
- LV機能障害 (平均エジェクション分数0.28) を有する13人の男性患者が登録されました.
- ヘモダイナミックパラメータ (動脈血圧,中央静脈圧) とSNAは,右心房-RV,RA-LV,RA-BVのペースを3分間にわたって,副鼻腔リズムより10ビート速いペースで記録しました.
主要な成果:
- 動脈血圧は,RVペースと比較して,LVとBVペースで有意に高かった (P<0.05).
- SNAは,LVとBVのペースアップ時に,RVのペースアップと比較して有意に低かった (P<0.02).
- ペースモードの間では,中央静脈圧の有意な差は観察されなかった.
結論:
- LVベースのペース,LVとVVペースを含むLVベースのペースは,LV機能不全の患者のVRペースと比較して,血液動力学を改善し,SNAを減少させます.
- これらの利点は,QRSの持続時間に関係なく観察されています.
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