对心脏再同步治疗的右心室反应:一个三维和斑点跟踪回声心脏学研究
Moustafa Dawood1, Eman Elsharkawy1, Moustafa Nawar1
1Department of Cardiology and Angiology, Faculty of Medicine, Alexandria University, Egypt.
The American journal of cardiology
|August 20, 2023
概括
心脏再同步治疗 (CRT) 改善了右心室 (RV) 功能和体积,特别是在对左心室 (LV) 治疗有反应的患者中. 这种反向改造与CRT的整体成功有关.
科学领域:
- 心脏病学 心脏病学
- 心脏成像 - - 心脏成像
- 心脏衰竭管理的管理
背景情况:
- 已知心脏再同步治疗 (CRT) 可以改善左心室 (LV) 功能.
- 对于CRT对右心室 (RV) 体积和功能的影响仍然不太了解.
- 评估RV改造对于了解CRT的综合影响至关重要.
研究的目的:
- 评估CRT对VR体积和缩功能的影响.
- 为了确定VR对CRT反应的预测因素.
- 为了将VR变化与CRT对LV反应相关联.
主要方法:
- 对63名接受CRT植入的患者进行前性研究.
- 使用2D/3D心声回声和斑点跟踪进行LV,左心房 (LA) 和RV评估.
- 评估的RV参数包括应变 (RV4CSL,RVFWSL),维度和射出分数在基线和后续.
主要成果:
- 响应LV治疗 (LVR) 的患者表现出显著的VR反向重塑和改善缩性表现.
- LVR组经历了RV基底直径的减少,改善了RV静脉缩速度,部分面积变化,RV应变,以及3D衍生RV体积/射出分数.
- 3个月后LV响应,RV4CSL变化和LA参数预测了VR响应;减少LV末缩体积>13.5%是一个强有力的预测因素.
结论:
- CRT可以诱导反向改造,并改善RV功能和RV动脉合.
- 对CRT的RV反应与左侧心脏反应相关,并由左侧心脏反应预测.
- 心声学参数,特别是LV重塑,是CRT在RV有效性的关键指标.
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