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超声心动图对不同频率AAI及VVI起搏的血流动力学研究 |
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沈建秀 顾复生 王安安 宁静 刘庆山
【摘要】 目的 本研究的目的在于评价不同频率AAI及VVI起搏的血流动力学效果，探索最佳起搏频率范围，比较AAI及VVI起搏的血流动力学效果。方法 37例植入永久心脏起搏器的患者分为两组，AAI组17例，VVI组20例。程控起搏频率从50～100次/分，以超声心动图评价其血流动力学效果。结果 在AAI起搏组，70次/分起搏的心排血量(CO)高于50及60次/分起搏(P<0.05)。80～90次/分起搏的CO变化无显著性差异。100次/分起搏的CO低于90次/分起搏。在VVI起搏组，起搏频率超过80次/分时，CO不再增高，110次/分起搏的CO甚至低于70次/分起搏，左室射血分数(LVEF)则随之下降。但AAI起搏的CO及LVEF在起搏频率相同情况下显著高于VVI起搏组。结论 在有心脏病的患者，最佳起搏频率范围较窄，为70～80次/分。AAI起搏的血流动力学效果显著优于VVI起搏。
【关键词】 超声心动描记术，多普勒，彩色 心脏起搏，人工 血液动力学
Echocardiographic study of the hemodynamics of AAI and VVI pacing Shen Jianxiu1, Gu Fusheng2, Wang Anan2, et al. 1 China Hewlett Packard Company Ltd, Beijing 100004; 2 Beijing Friendship Hospital, Beijing 100050
【Abstract】 Objective To evaluate the hemodynamic consequences of varying pacing rates in AAI and VVI pacing, in order to find out the optimal pacing rate range and to compare the hemodynamic effects of AAI and VVI pacing.Methods Thirty seven patients with permanent cardiac pacing were divided into 2 groups of AAI (n=17) and VVI (n=20) pacing. The pacing rate was programmed from 50-100 beats/min. The pacing hemodynamics were evaluated by echocardiography.Results Cardiac output(CO) increased with increasing pacing rate in both AAI and VVI pacing. In AAI pacing, CO was higher at 70 beats/min than at 50-60 beats/min (P<0.05). CO remained stable within 80-90 beats/min, but was lower at 100 beats/min than at 90 beats/min. In VVI pacing, CO was higher at 70 beats/min than at 50 beats/min (P<0.05) and showed no increase when the pacing rate increased over 80 beats/min. At 100 beats/min, both CO and LVEF (left ventrical ejection fraction) were even lower than that at 70 beats/min. CO and LVEF of AAI pacing were significantly higher than VVI pacing at the same pacing rate(P<0.001).Conclusion Patients with heart disease and impaired cardiac function have a narrow range of optimal pacing rates which is 70-80 beats/min. The hemodynamic effect of AAI pacing [1] [2] [3] 下一页
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