左心室的体积和功能在成功和失败的His-BundLe节奏中. 一个比较的前性研究
Francesco Notaristefano1, Alberto Barengo2, Lorenzo Spighi3
1Department of Cardiology, Hospital S. Maria della Misericordia, Perugia, Italy.
Journal of cardiovascular electrophysiology
|September 10, 2024
概括
他的捆绑节奏 (HBP) 比右心室节奏 (RVP) 更好地保持心脏功能. 成功的HBP可以避免节奏诱导心肌病 (PICM),即使节奏负担很高.
科学领域:
- 心脏病学 心脏病学
- 心脏电生理学 心脏电生理学
- 心血管成像 - 心血管成像
背景情况:
- 有限的证据表明,他的捆绑节奏 (HBP) 可能会比右心室节奏 (RVP) 更好地保护心脏结构和功能.
- 需要进一步的研究来证实与RVP相比,HBP的长期益处.
研究的目的:
- 为了比较成功的His捆节奏 (HBP) 与右心室节奏 (RVP) 对心脏结构和功能的长期影响.
- 为了评估在接受HBP和RVP的患者中,节奏诱导心肌病 (PICM) 的发生率.
主要方法:
- 对68名患者进行前性研究,基线射出分数 (EF) ≥50%,接受HBP试验 (成功的HBP组或失败的RVP组).
- 两维 (2D) 和三维 (3D) 心声谱在基线和节奏节奏后6个月进行,>20%的心室节奏负担.
- 分析包括EF,全球纵向应变 (GLS) 和PICM发生率 (EF下降≥10%和EF<50%).
主要成果:
- 6个月后,RVP组显示2D EF (-3.86%) 和3D EF (-5.71%) 显著下降,而HBP组显示没有变化 (p<0.001).
- 在RVP组,GLS显著增加,但在HBP组保持不变 (p<0.016).
- 在RVP患者中,PICM发生在14%的患者中,而在HBP患者中为0% (p=0.025).
结论:
- 与RVP相比,成功的HBP优异地保持了左心室缩功能,尽管心室节奏负担很高.
- 高血压与显著较低的节奏诱导心肌病 (PICM) 发病率有关.
- 在需要心室节拍的患者中,HBP是RVP的可行的替代方案,以保持心脏功能.
相关概念视频
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