右心室节拍部位对右心室功能的影响:系统性审查和元分析
Sean DeAngelo1, Badri Aryal1, Maryam Haghshomar2
1Department of Medicine, John H Stroger Jr Hospital of Cook County Chicago, IL, US.
Arrhythmia & electrophysiology review
|March 2, 2026
概括
右心室 (RV) 节奏显著影响RV功能,特别是减少三侧环状缩速度 (S'). 顶端节奏表现出最有害的影响,而左捆分支区域节奏 (LBBAP) 提供了更好的结果.
科学领域:
- 心脏病学和心血管研究
- 医疗器械技术 医疗器械技术
- 心声成像和心脏成像技术
背景情况:
- 传统的双腔起器可能会对左心室产生负面影响,导致节奏诱导的心肌病.
- 右心室 (RV) 节奏对RV重塑和功能的影响与其对左心室功能的影响相比,仍然不太了解.
研究的目的:
- 系统地审查和元分析RV节奏对各种右心室回声心脏学参数的影响.
- 调查RV节奏后节奏部位和持续时间对RV功能的影响.
主要方法:
- 按照PRISMA指南进行的系统审查和元分析.
- 搜索了Embase,PubMed和SCOPUS数据库,从创立到2024年3月.
- 包括18项研究 (1,220名患者) 分析RV射出分数 (RVEF),肺动脉静脉压 (sPAP),三环状平面静脉外流 (TAPSE),心肌性能的RV指数 (RIMP) 和三侧环状静脉速度 (S').
主要成果:
- 在RV节奏测试中,S'显著降低 (整体平均差异为-1.3522 cm/s,p=0.0089).
- 没有观察到RVEF,TAPSE,RIMP,2D微分面积变化 (FAC) 或sPAP的显著变化.
- 节奏部位显著影响TAPSE,S',FAC和sPAP,其中角节奏显示出最有害的影响,而LBBAP显示出更好的结果.
结论:
- RV节奏与S'和其他回声心脏学参数的显著减少有关,节奏部位是异质性的主要驱动因素.
- 角节奏对RV功能产生了最不利的影响,而LBBAP与更有利的结果有关.
- 需要进一步的研究来探索残留异质性和其他影响因素.
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