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首页> 外文期刊>Circulation journal >Right ventricular septal pacing preserves global left ventricular longitudinal function in comparison with apical pacing. -Analysis of speckle tracking echocardiography-.
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Right ventricular septal pacing preserves global left ventricular longitudinal function in comparison with apical pacing. -Analysis of speckle tracking echocardiography-.

机译:与心尖起搏相比,右心室间隔起搏保留了总体左心室纵向功能。 -斑点跟踪超声心动图分析。

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BACKGROUND: Right ventricular (RV) pacing alters left ventricular (LV) mechanical activation, resulting in adverse impacts on LV function. This study was aimed to investigate the acute effect of RV apical (RVA) and septal pacing (RVS) on LV dyssynchrony and function using speckle tracking echocardiography. METHODS AND RESULTS: The 103 patients (749 years) with symptomatic bradyarrhythmia and preserved LV ejection fraction, and 50 age-matched control subjects were studied. All patients received a permanent pacemaker and were randomly assigned into 2 groups (RVA: n = 51, RVS: n = 52). After insertion, patients underwent an echocardiographic study during RV pacing. LV dyssynchrony and global strain parameters were analyzed using speckle tracking echocardiography. The QRS width and dyssynchrony indices by longitudinal and radial strain were significantly greater in RVA than in both the control and RVS. The LV longitudinal dyssynchrony index was significantly related to global longitudinal strain (GLS) among 103 patients receiving RV pacing (R(2) = 0.25, P < 0.0001). The GLS in RVA were the lowest among the 3 groups (GLS: Control: -18.22.4%, RVA: -14.33.1%, P < 0.001 vs. control, RVS: -16.82.7%, P<0.01 vs. RVA). CONCLUSIONS: RVA created heterogeneous LV contraction, which resulted in deteriorated LV longitudinal contraction. RVS could be a better pacing alternative in terms of less LV dyssynchrony and better longitudinal function compared to RVA.
机译:背景:右心室(RV)起搏会改变左心室(LV)的机械激活,从而对LV功能产生不利影响。本研究旨在通过散斑跟踪超声心动图研究右心室(RVA)和间隔起搏(RVS)对左室不同步和功能的急性影响。方法与结果:对103例(749岁)有症状的心律失常并保持左室射血分数的患者和50例年龄匹配的对照组进行了研究。所有患者均接受永久性起搏器,并随机分为2组(RVA:n = 51,RVS:n = 52)。插入后,患者在RV起搏期间接受超声心动图检查。使用斑点追踪超声心动图分析左室不同步和整体应变参数。 RVA的纵向和径向应变的QRS宽度和不同步指数显着大于对照组和RVS。在103例接受RV起搏的患者中,LV纵向不同步指数与总体纵向应变(GLS)显着相关(R(2)= 0.25,P <0.0001)。 RVA中的GLS在3组中最低(GLS:对照组:-18.22.4%,RVA:-14.33.1%,P <0.001 vs.对照组,RVS:-16.82.7%,P <0.01 vs. RVA)。结论:RVA造成左室收缩不均一,导致左室纵向收缩恶化。与RVA相比,RVS可以减少左室不同步和更好的纵向功能,从而成为更好的起搏选择。

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