左心室或双心室节奏改善心脏功能,降低了扩张性心肌病和左束枝状阻塞患者的能量成本
G S Nelson1, R D Berger, B J Fetics
1Division of Cardiology, Department of Medicine, The Johns Hopkins Medical Institutions, Baltimore, MD, USA.
Circulation
|January 11, 2000
概括
左心室或双心室节奏改善了扩张心肌病患者的缩功能,而不会增加心肌氧消耗. 这种心脏再同步疗法为失同心力衰竭提供了有价值的治疗策略.
科学领域:
- 心脏病学 心脏病学
- 心脏衰竭研究研究
- 生物医学工程 生物医学工程
背景情况:
- 扩张性心肌病 (DCM) 患者的导电延迟经历了通过心室节奏来改善缩功能.
- 增强缩功能的常规疗法往往会增加心肌的氧气需求.
- 这项研究调查了心室节奏是否可以在不增加能量需求的情况下提供缩性益处.
研究的目的:
- 为了确定DCM患者的左心室或双心室节奏是否有左束分支阻塞增强缩功能.
- 与多布胺相比,评估心室节拍对心肌氧消耗 (MVO(2) 的影响.
主要方法:
- 在10名DCM患者的心脏导管测量血液动力学参数和MVO(2) 在鼻节律和节奏.
- 与7名DCM患者的dobutamine输注对节奏效应的比较.
- 测量包括心室/大动脉压力,冠状动脉血流和动脉-冠状动脉鼻氧气差 (DeltaAVO) (2).
主要成果:
- 在DCM患者中,左心室 (LV) 节奏显著增加了缩功能 (动脉脉冲压,dP/dt(max)).
- 激发LV带来了DeltaAVO(2) 和MVO(2) 的下降,表明能源成本降低.
- 与节奏相比,多布他胺增加了缩功能,但也显著增加了MVO.
结论:
- 通过LV或双心室节拍进行心室再同步,可在DCM患者中急性增强心功能,以左束支阻断.
- 节奏疗法适度降低心肌能耗,与多布胺不同.
- 这种方法对于患有基底失调的DCM患者来说是一个有前途的治疗方法.
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