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首页> 外文期刊>American Journal of Physiology >Biventricular mechanical asynchrony predicts hemodynamic effect of uni- and biventricular pacing.
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Biventricular mechanical asynchrony predicts hemodynamic effect of uni- and biventricular pacing.

机译：双心室机械性异步预测了单心室和双心室起搏的血流动力学效应。

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摘要

We tested whether biventricular resynchronization explains contractile function changes with univentricular and biventricular pacing in heart failure patients with varying magnitudes of baseline biventricular asynchrony. Thirty patients (New York Hospital Association class > or = III, QRS duration > or =120 ms) were tested. Contractile function was measured by left ventricular maximum first derivative of pressure over time (dP/dtmax). Biventricular mechanical asynchrony was quantified by the normalized pressure-pressure (NPP) loop area formed by the cross-plot of right and left intraventricular pressure curves from each cardiac cycle. Any ventricular pacing increased dP/dtmax if it decreased baseline NPP loop area and almost always worsened dP/dtmax and asynchrony when baseline NPP loop area <0.3. The quantitative relationship between dP/dtmax and NPP loop area change depended on ventricular pacing site and timing relative to intrinsic activation. For similar NPP loop decreases, dP/dtmax increased 16% more with left and biventricular pacing compared with right ventricular pacing. In conclusion, right, left, or biventricular pacing can improve contractile function only in patients having sufficient baseline biventricular asynchrony. However, biventricular resynchronization is only one of the improvement mechanisms.
机译：我们测试了双心室再同步是否解释了在基线双心室异步程度不同的心力衰竭患者中，单心室和双心室起搏引起的收缩功能变化。测试了30例患者（纽约医院协会等级>或= III，QRS持续时间>或= 120 ms）。通过左心室压力随时间的最大一阶导数（dP / dtmax）来测量收缩功能。通过每个心动周期左右心室内压曲线的交点形成的归一化压力-压力（NPP）回路面积来量化双心室机械性异步。如果降低基线NPP环面积，任何心室起搏都会增加dP / dtmax，而当基线NPP环面积<0.3时，几乎总是使dP / dtmax和异步性恶化。 dP / dtmax与NPP环面积变化之间的定量关系取决于心室起搏部位和相对于内在激活的时间。对于类似的NPP环路下降，与右心室起搏相比，左心室和双心室起搏使dP / dtmax增加16％。总之，右，左或双心室起搏仅可在具有足够基线双心室异步性的患者中改善收缩功能。但是，双心室再同步只是改善机制之一。

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