[1]汪汉 蔡琳邓晓奇 李锦 童琳 刘汉雄.双心室起搏模式下心力衰竭患者的心脏研究[J].心血管病学进展,2022,(4):380-384.[doi:10.16806/j.cnki.issn.1004-3934.2022.04.022]
　WANG Han,CAI lin,DENG Xiaoqi,et al.Cardiac Electromechanical Coupling in Patients with Heart Failure under Biventricular Pacing Mode[J].Advances in Cardiovascular Diseases,2022,(4):380-384.[doi:10.16806/j.cnki.issn.1004-3934.2022.04.022]
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双心室起搏模式下心力衰竭患者的心脏研究()
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《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2022年4期
页码:
380-384
栏目:
论著
出版日期:
2022-04-25

文章信息/Info

Title:
Cardiac Electromechanical Coupling in Patients with Heart Failure under Biventricular Pacing Mode
作者:
汪汉 蔡琳邓晓奇 李锦 童琳 刘汉雄
(西南交通大学附属医院 成都市第三人民医院心内科成都市心血管病研究所，四川成都 610031）
Author(s):
WANG Han;  CAI lin;  DENG Xiaoqi;  LI Jin;  TONG lin;  LIU Hanxiong
(The Affiliated Hospital of Southwest Jiaotong University, Cardiovascular Department of the Third People’s Hospital of Chengdu, Chengdu 610031, Sichuan, China)
关键词:
心室起搏; 心力衰竭; 心脏; 心脏再同步化治疗
Keywords:
Biventricular pacing;  Heart failure;  Cardiac electromechanical coupling;  Cardiac resynchronization therapy
DOI:
10.16806/j.cnki.issn.1004-3934.2022.04.022
摘要:
目的 探讨双心室起搏模式下心力衰竭患者心脏的数量关系，设置理想VV间期。方法 选择2007年6月2009年4月准备行心内电生理检查的心力衰竭患者20，标测电极导管于左室后游离壁、右室心尖、左室前间隔右室前间隔4个部位，通过Ensite Array非接触式标测球囊多电极导管记录电同步性，以彩色多普勒超声诊断仪的向量速度显像记录机械同步性，分析电活动及机械运动的耦联关系。结果 ΔT电机械在空间分布上具有不匀性，且与心室解剖部位密切相关0.001），双心室起搏引起的机械收缩同时到达中心部位的VV间期可表述为0.5（LVPace～PRVPace～A）。结论 心力衰竭患者心脏电与机械活动存在不同步性，利用原理可设计较为理想的VV间期。
Abstract:
Objective To explore the quantitative relationship on cardiac electromechanical coupling of heart failure patients in biventricular pacing mode and provide a new algorithm on setting an ideal VV interval. Methods A total of 20 patients with heart failure underwent electrophysiological examination from June 2007 to April 2009 were enrolled. The electrode catheter was placed in left ventricular posterior free wall, right ventricular apex, left and right ventricular anterior septum. The electronical synchronization was recorded by Ensite Array non-contacting mapping-balloon multielectrode catheter and the mechanical synchronization recorded by vector velocity imaging of Doppler echocardiography. The coupling relationship between electrical activity and mechanical motion was analyzed. Results The differences between the start time of electrical activation and the time of mechanical movement showed an uneven spatial distribution and were closely related to ventricular anatomical sites (P＜0.001). The VV interval of mechanical contraction simultaneously reaching the center caused by biventricular pacing could be expressed as “0.5(LVPace~P－RVPace~A)”. Conclusion There exists an asynchrony between cardiac electrical and mechanical activity in patients with heart failure. An ideal VV interval could be set on the principle of electromechanical coupling.

参考文献/References:

[1] Normand C,Dickstein K. Guideline recommendations for cardiac resynchronization therapy evolve but does clinical practice match the pace?[J]. Eur J Heart Fail,2018,20(4):778-779.
[2] 刘汉雄蔡琳邓晓奇等. 心脏再同步化治疗快速优化新算法. 中华心律失常学杂志2013,17(4):275-279.
[3] Wang H,Deng X,Li J,et al. A simplified method for determination of the optimal atrioventricular delay in cardiac resynchronization therapy[J]. Int J Cardiol,2014,176(3):1239-1241.
[4] Gold MR,Yu Y,Singh JP,et al. Effect of interventricular electrical delay on atrioventricular optimization for cardiac resynchronization therapy[J]. Circ Arrhythm Electrophysiol,2018,11(8):e006055.
[5] Donal E,Galli E,Cosyns B. Twenty years after starting cardiac resynchronization therapy,do we understand the electromechanical coupling?[J]. Eur Heart J Cardiovasc Imaging,2019,20(3):257-259.
[6] Payne JE,Gold MR. Optimization of cardiac resynchronization therapy: should perioperative hemodynamic measurements be routine?[J]. JACC Clin Electrophysiol,2019,5(9):1026-1102.

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备注/Memo

备注/Memo:
收稿日期：2021-06-23
基金项目：中国健康与医疗发展基金会（NCT00918294-2008-zhFj1）；成都市十一五科技攻关重大专项（07YTYB957SF-020）
更新日期/Last Update: 2022-05-13