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Case Report: Pathophysiology of narrow complex dilated cardiomyopathy insight derived from the velocity equation: velocity = distance/time

机译：病例报告：狭窄的复杂性扩张型心肌病的病理生理学从速度方程得出：速度=距离/时间

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The pathophysiology of narrow complex dilated cardiomyopathy is not defined, so therapeutic options are limited. By utilising the velocity equation, the pathophysiology of narrow complex cardiomyopathy allows above normal conduction propagation velocities. There are two pathophysiological theories that allow above normal conduction velocities and failure to capture the myocardium: (1)insulating fibres of the conduction system extending beyond the apex and (2) reduction of axon branching. A patient with narrow complex cardiomyopathy was subjected to graded increase in amplitude and pulse width pacing to overcome the failure of native conduction to capture the myocardium. Peak systolic strain maps demonstrated a progressive increase in apical contractility with increasing pulse width and amplitude. Ejection fraction improved from 17% to 31%. Understanding the pathophysiology of narrow complex cardiomyopathy leads to proposed therapies. One potential pacing therapy is multi-lead pacing at high amplitude and pulse width to capture myocardial cells not captured by native conduction.

机译：狭窄的复杂性扩张型心肌病的病理生理学尚未定义，因此治疗选择受到限制。通过利用速度方程，狭窄的复杂性心肌病的病理生理学允许高于正常的传导传播速度。有两种病理生理学理论可以使传导速度超过正常水平，并且无法捕获心肌：（1）传导系统的绝缘纤维延伸至根尖以外；（2）轴突分支减少。患有狭窄的复杂性心肌病的患者经历幅度和脉宽起搏的逐步增加，以克服固有传导捕获心肌的失败。收缩期峰值应变图显示，随着脉宽和幅度的增加，心尖收缩力逐渐增加。射血分数从17％提高到31％。了解狭窄的复杂性心肌病的病理生理学导致提出了治疗方法。一种潜在的起搏疗法是在高振幅和脉冲宽度下多导联起搏以捕获未被自然传导捕获的心肌细胞。

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期刊名称 BMJ Case Reports
作者
Philip D Houck; Billy Jones; Rikin Patel; Greg Olsovsky;
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作者单位

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年(卷),期 2019(12),8
年度 2019
页码 e229339
总页数 6
原文格式 PDF
正文语种
中图分类
关键词
cardiovascular medicine heart failure pacing and electrophysiology;

机译：心血管医学;心力衰竭;起搏和电生理;

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Case Report: Pathophysiology of narrow complex dilated cardiomyopathy insight derived from the velocity equation: velocity = distance/time

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