双室节奏在高压阻塞性心肌病症中的影响
X Jeanrenaud1, J J Goy, L Kappenberger
1Department of Internal Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
Lancet (London, England)
|May 30, 1992
概括
双室节奏提供了一个非手术的替代方案,用于过敏阻塞性心肌病. 这种疗法有效地降低了压力梯度,改善了患者的症状,提供了长期的好处.
科学领域:
- 心脏病学 心脏病学
- 医疗器械 医疗器械
背景情况:
- 强迫性阻塞性心肌病 (HOCM) 经常需要对耐火病例进行手术干预.
- 双室节拍是一种潜在的非手术治疗选择.
研究的目的:
- 评估HOCM患者急性和长期双室节奏的疗效.
- 评估节奏对心室内压力梯度和功能能力的影响.
主要方法:
- 在13名HOCM患者中研究了双室节奏的急性和长期影响.
- 针对个体患者,优化心房 (AV) 间隔 (50-90毫秒).
- 在长达62个月的时间里,监测压力梯度,心脏输出和临床症状 (心肌痛,呼吸障碍).
主要成果:
- 在12/13名患者中,急性AV序列节奏显著降低了下大动脉峰值压力梯度 (82至47毫米升,p<0.002).
- 长期节奏改善了功能能力,减少了从NYHA类3到1的胸痛和从类3到2的呼吸障碍.
- 观察到阻塞减少的趋势,隔膜厚度或收缩性没有显著变化.
结论:
- 在优化的AV间隔下同步的双室节奏有效地降低了HOCM中的心室内压力梯度.
- 这种非手术疗法在功能耐受性方面提供了显著而持久的改善.
- 双室节奏是选择HOCM患者手术的可行替代方案.
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