心脏再同步对心肌效率和区域氧化代谢的影响
Heikki Ukkonen1, Rob S B Beanlands, Ian G Burwash
1Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
Circulation
|January 8, 2003
概括
心脏再同步治疗 (CRT) 在心力衰竭患者中增强左心室功能和心肌效率. 这种改善发生在没有增加整体氧化代谢的情况下,表明更有效的能源使用.
科学领域:
- 心脏病学 心脏病学
- 生物医学工程 生物医学工程
- 核医学是一种核医学.
背景情况:
- 心脏再同步治疗 (CRT) 与心房双心室刺激已经显示出改善左心室收缩性的承诺.
- 这项研究调查了CRT对心肌氧化代谢和晚期心力衰竭患者的效率的影响.
研究的目的:
- 评估CRT对心肌氧化代谢和充血性心力衰竭患者的效率的影响.
- 用[11C]乙酸盐和正子辐射断层扫描来评估心肌氧化代谢的变化.
- 通过工作代谢指数 (WMI) 确定CRT对心肌效率的影响.
主要方法:
- 研究了八名患有NYHA类III-IV心力衰竭的患者.
- 使用[11C]乙酸盐的正子发射断层扫描被用来测量心肌氧化代谢的单指数清除率 (k(mono)).
- 用工作代谢指数 (WMI) 评估心肌效率.
- 患者在心房节拍 (对照) 和心房双心室刺激期间以匹配的速度被研究.
主要成果:
- 使用CRT (P=0.011),中风体积指数提高了10%.
- 全球左心室和右心室氧化代谢 (k ((mono)) 保持不变.
- 隔膜k ((mono) 增加了15% (P=0.04),隔膜/侧壁的比率增加了22% (P=0.01).
- 使用CRT,心肌效率 (WMI) 增加了13% (P=0.024) .
结论:
- CRT可以改善左心室功能和心肌效率,而不会增加全球氧化代谢.
- 与侧壁相比,隔膜氧化代谢的观察到的增加表明成功重同步.
- 在心力衰竭患者中,CRT提供了一种改善心脏效率的方法.
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