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目的探讨植入双腔起搏器(DDD)术后患者不同房室延迟(AVD)、不同起搏状态对左室舒张功能的影响。方法选择30例接受DDD心脏起搏器治疗的病窦综合征患者,术后随访时,通过程控调节患者的AVD,采用彩色多普勒超声心动图测量不同起搏状态下患者的Tei指数、早期二尖瓣减速时间(DT)与舒张早期运动速度/舒张晚期运动速度(Em/Am)等左室舒张功能指标,用免疫荧光法测定血浆B型利钠肽(BNP),并比较不同起搏状态下以上各指标的差异。结果部分起搏与全部起搏状态下的心脏彩超舒张功能指标及BNP比较差异有显著性(<0.01),全部下传与部分起搏状态下的心脏彩超舒张功能指标及BNP比较差异有显著性(<0.01)。结论全部下传状态下患者的左室舒张功能最佳,提示AVD的选择对植入DDD的病窦综合症病人有重要意义。
Objective To investigate the effects of different atrioventricular delay (AVD) and different pacing status on left ventricular diastolic function in patients undergoing double-chamber pacemaker implantation. Methods Thirty patients with sick sinus syndrome treated with DDD cardiac pacemaker were selected. During the follow-up period, the patients’ AVD was adjusted by program-controlled. Color Doppler echocardiography was used to measure the Tei index of patients under different pacing conditions. Left ventricular diastolic function indexes such as mitral decelerating time (DT) and early diastolic velocity / early diastolic velocity (Em / Am), plasma BNP was measured by immunofluorescence and compared with different pacing The state of the above indicators of the difference. Results Compared with BNP, the parenchymal diastolic function index and BNP in partial pacing and all paced status were significantly different (all P <0.01). There were significant differences in diastolic function and BNP between all pacing and partial pacing (<0.01). Conclusion All patients under the state of the best left ventricular diastolic function, suggesting that the choice of AVD implantation of DDD patients with sinus syndrome is important.