双静脉节拍改善了在心力衰竭和导电延迟患者的单静脉节拍期间存在的形力频率关系
Dirk Vollmann1, Lars Lüthje, Peter Schott
1Department of Cardiology and Pneumology, Georg-August-University, Göttingen, Germany. DirkVollmann2000@aol.com
Circulation
|February 16, 2006
概括
在慢性心力衰竭患者中,随着心率的增加,双管管节奏改善了心脏功能,与单位节奏不同. 这表明双心室节奏为再同步治疗提供了功能上的好处.
科学领域:
- 心脏病学 心脏病学
- 心脏电生理学 心脏电生理学
- 心脏衰竭管理的管理
背景情况:
- 患有慢性心力衰竭 (CHF) 和导电延迟的患者通常会出现心功能受损.
- 双心室 (BiV) 和左心室 (LV) 节奏在这些患者中改善了静止时的缩功能.
- 节奏在增加心率时对收缩功能的影响尚不清楚.
研究的目的:
- 为了研究BiV和单静脉节奏对心脏收缩功能在增加心率的差异性影响在CHF患者.
- 为了比较BiV,LV和右心室 (RV) 节奏期间的力频关系.
主要方法:
- 22名心脏衰竭患者接受了心脏导管治疗.
- 左心室 (LV) 血液动力学在BiV,LV和RV刺激期间以不同的心率 (80,100,120,140 bpm) 测量.
- 评估的关键参数包括LV末端透气压 (LVEDP),LV静脉压 (LVSP) 和dP/dtmax.
主要成果:
- 与基线和RV节奏相比,BiV和LV节奏在80bpm时同样增加了dP/dtmax.
- 增加心率从80到140bpm显著提高dP/dtmax在BiV节拍期间.
- 随着心率的增加,在单位LV或RV节奏中没有观察到显著的收缩性改善.
- 在每分钟140拍时,BiV节奏导致较低的LVEDP和较高的LVSP,与RV和LV节奏相比.
结论:
- 室腔刺激模式改变了体内强力频率关系在CHF患者.
- 收缩功能在BiV刺激期间随着心率的增加而改善,与单位节奏不同.
- 这种增强的反应可能有助于提高运动能力,并为心脏再同步治疗提供了与LV-only节奏相比的潜在益处.
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