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首页> 外文期刊>PACE: Pacing and clinical electrophysiology >Hemodynamic assessment of right, left, and biventricular pacing by peak endocardial acceleration and echocardiography in patients with end-stage heart failure.
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Hemodynamic assessment of right, left, and biventricular pacing by peak endocardial acceleration and echocardiography in patients with end-stage heart failure.

机译：晚期心力衰竭患者的峰值心内膜加速和超声心动图对右，左和双心室起搏的血流动力学评估。

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Multisite ventricular pacing acutely improves the hemodynamic status in heart failure, though longer-term observations require invasive procedures. The hemodynamics of multisite ventricular pacing were assessed by echocardiography and peak endocardial acceleration (PEA) measured by a pacemaker sensor. PEA variations are highly correlated with those of dP/dt. Thirteen end-stage heart failure patients (left ventricular ejection fraction < 0.30) with a QRS > or = 140 ms received a DDD PEA sensor-driven pacemaker allowing right (RV), left (LV) and biventricular (BV) pacing. Ten days after implantation, standard echocardiographic parameters and variations in PEA were measured after 20 minutes at each pacing mode. The aortic systolic preejection time interval was statistically comparable between RV and LV pacing (218 +/- 24 vs 219 +/- 34 ms; P = NS), and significantly shorter with BV pacing (198 +/- 27 ms; P = 0.013). Aortic ejection duration was nonsignificantly shorter during BV pacing than during LV pacing (-.061, P = 0.09). The aortic velocity time integer increased during LV pacing versus RV pacing (+21%, P < 0.05) and during BV pacing versus RV pacing (+37%, P = 0.05). As a result, the values of the PEA variations over a 15-minute period were significantly greater during LV pacing and BV pacing versus RV pacing (+43%, P < 0.05, and +38%, P = 0.05, respectively) and were statistically comparable between BV pacing and LV pacing (9% for LV pacing, P = NS). During various ventricular pacing configurations, PEA measurements were consistent with echocardiographic data, showing comparable hemodynamic effects of BV and LV pacing. The PEA sensor is a promising tool for long-term hemodynamic monitoring and serial evaluation of the effects of multisite ventricular pacing in heart failure patients.
机译：尽管长期观察需要侵入性治疗，但多部位心室起搏可显着改善心力衰竭的血液动力学状态。通过超声心动图评估多部位心室起搏的血流动力学，并用起搏器传感器测量心内膜峰值加速度（PEA）。 PEA变化与dP / dt高度相关。 13名QRS≥140 ms的晚期心力衰竭患者（左心室射血分数<0.30）接受DDD PEA传感器驱动的起搏器，可进行右（RV），左（LV）和双心室（BV）起搏。植入后十天，在每种起搏模式下20分钟后，测量标准超声心动图参数和PEA的变化。在RV和LV起搏之间主动脉收缩前喷射时间间隔在统计学上相当（218 +/- 24与219 +/- 34 ms; P = NS），而在BV起搏时（198 +/- 27 ms; P = 0.013 ）。 BV起搏期间的主动脉射血持续时间明显短于LV起搏期间的主动脉射血持续时间（-.061，P = 0.09）。在LV起搏与RV起搏之间（+ 21％，P <0.05）和BV起搏与RV起搏期间（+ 37％，P = 0.05），主动脉速度时间整数增加。结果，与RV起搏相比，LV起搏和BV起搏在15分钟内的PEA变化值明显更高（分别为+ 43％，P <0.05和+ 38％，P = 0.05），并且分别为BV起搏和LV起搏在统计上具有可比性（LV起搏为9％，P = NS）。在各种心室起搏配置中，PEA测量值与超声心动图数据一致，显示出BV和LV起搏可比的血液动力学效应。 PEA传感器是用于心衰患者的长期血流动力学监测和多部位心室起搏效果的连续评估的有前途的工具。

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