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首页> 外文期刊>Journal of cardiac failure >Improved response to cardiac resynchronization therapy through optimization of atrioventricular and interventricular delays using acoustic cardiography: a pilot study.
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Improved response to cardiac resynchronization therapy through optimization of atrioventricular and interventricular delays using acoustic cardiography: a pilot study.

机译：通过使用声学心动图优化房室和心室延迟来改善对心脏再同步治疗的反应：一项初步研究。

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BACKGROUND: The purpose of this pilot study was to determine the utility of acoustic cardiography for the optimization of atrioventricular (AV) and interventricular (VV) delays in cardiac resynchronization therapy (CRT). METHODS AND RESULTS: We evaluated 14 patients (86% male, mean age 64 +/- 9 years, mean time since implant 15 +/- 18 months). Subjects were enrolled >10 weeks after CRT implant. Spiroergometry and 2-dimensional/3-dimensional echocardiography were used to assess cardiac performance for "out-of-the-box" settings (baseline settings: AV 120 ms, VV 0 ms) versus optimal settings (determined by acoustic cardiography). Cardiac performance measurements were performed 6 weeks after settings were modified. Optimal AV/VV settings were determined based on the lowest electromechanical activation time (EMAT, the time from the onset of QRS to the mitral valve component of the first heart sound). Statistical analysis was performed using a paired 2-tailed Student's t-test. In comparison to "out-of-the-box" settings, AV/VV delay optimization with acoustic cardiography improved cardiac performance as indicated by significant changes in work capacity, maximum oxygen uptake, oxygen pulse, ejection fraction, end-systolic volume, and velocity-time integral in left ventricular outflow tract. CONCLUSIONS: AV and VV optimization by acoustic cardiography produces significant improvements in objective clinical and hemodynamic parameters in comparison to typical "out-of-the-box" settings.
机译：背景：这项初步研究的目的是确定超声心动图在优化心脏再同步治疗（CRT）中的房室（AV）和心室（VV）延迟方面的实用性。方法和结果：我们评估了14例患者（86％的男性，平均年龄64 +/- 9岁，植入后平均时间15 +/- 18个月）。 CRT植入后> 10周入组受试者。肺功能描记法和二维/ 3维超声心动图用于评估“开箱即用”设置（基准设置：AV 120 ms，VV 0 ms）与最佳设置（由声学心动图确定）的心脏性能。修改设置后6周进行心脏功能测量。最佳的AV / VV设置是根据最低的机电激活时间（EMAT，即从QRS发作到第一次心音的二尖瓣成分的时间）确定的。使用配对的两尾学生t检验进行统计分析。与“开箱即用”的设置相比，通过心电图检查进行的AV / VV延迟优化改善了心脏性能，表现为工作能力，最大摄氧量，氧气脉冲，射血分数，收缩末期容积和左心室流出道的速度-时间积分。结论：与典型的“开箱即用”设置相比，通过心电图检查进行的AV和VV优化可以显着改善客观临床和血液动力学参数。

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