[1]路 飞,王妍妍△,胡 涛.不同起源频发室性早搏患者射频消融术后左心房功能及结构变化临床研究*[J].陕西医学杂志,2019,(12):1642-1645.
　LU Fei,WANG Yanyan,HU Tao..Clinical study on left atrial function and structure changes in patients with frequent premature ventricular contractions of different origins after RFCA[J].,2019,(12):1642-1645.
点击复制

不同起源频发室性早搏患者射频消融术后左心房功能及结构变化临床研究*
分享到：

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2019年12期
页码:
1642-1645
栏目:
临床研究
出版日期:
2019-12-05

文章信息/Info

Title:
Clinical study on left atrial function and structure changes in patients with frequent premature ventricular contractions of different origins after RFCA
文章编号:
DOI:10.3969/j.issn.10007377.2019.12.017
作者:
路 飞; 王妍妍△; 胡 涛
陕西省安康市中心医院心血管内科(安康 725000)
Author(s):
LU Fei; WANG Yanyan; HU Tao.
Department of Cardiology,Ankang Central Hospital (Ankang 725000)
关键词:
室性早搏; 射频消融术; 左心房功能; 脑钠肽; 心脏结构
Keywords:
Key words Premature ventricular contraction; Rediofrequency catheter ablation; Left atrial function; Brain natriuretic peptide; Heart structure
分类号:
R5417
文献标志码:
A
摘要:
摘 要 目的：研究不同起源频发室性早搏(PVC)患者射频消融术(RFCA)术后左心房功能及结构变化。方法：选取频发PVC患者105例和同期体检正常者50例(对照组)作为研究对象，根据频发PVC患者的起源分为右心室组71例和左心室组34例。记录三组对象左心房功能及结构情况，所有PVC患者均进行RFCA术，比较右心室组和左心室组患者治疗前后左心房功能及结构变化情况及血浆中脑钠肽(BNP)水平变化情况。结果：右心室组和左心室组患者的左心房内径(LAD)、左心室内径(LVD)、左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)、左心室后壁厚度(LVPWD)、左心房收缩期左心房应变率(SRa)均显著高于对照组(P＜005)，左心室每搏输出量(LVSV)、左心房射血分数(LAEF)、左心室射血分数(LVEF)显著低于对照组(P＜005)；与RFCA术前相比，右心室组患者LAD、LAEF、左心房应变(S)、SRa、左心室收缩期左心房应变率(SRs)等指标改善情况均优于左心室组，差异有统计学意义(P＜005)；右心室组和左心室组患者血浆BNP水平均显著高于对照组，RFCA术后水平明显降低，且右心室组患者降低更显著，差异具有统计学意义(P＜005)。结论：不同起源的频发PVC都伴随有左心房功能损伤且血浆中BNP水平升高，经过RFCA术治疗后，右心室起源PVC患者的左心房功能、结构及血浆中BNP水平改善均优于左心室起源PVC患者。
Abstract:
Abstract Objective:To study left atrial function and structure changes in patients with frequent premature ventricular contractions (PVC) of different origins after rediofrequency catheter ablation (RFCA)Methods:105 patients with frequent PVC and 50 patients with normal physical examination (control group) were selected as study subjectsExamination (control group) in the same period were enrolledAccording to origins of frequent PVC patients,they were divided into right ventricle group (71 cases) and left ventricle group (34 cases)The left atrial function and structure of the three groups before treatment were recordedAll PVC patients underwent RFCAThe changes in left atrial function and structure,and level of plasma brain natriuretic peptide (BNP) before and after treatment were compared between right ventricle group and left ventricle groupResults:Left atrial diameter (LAD),left ventricular diameter (LVD),left ventricular enddiastolic diameter (LVEDD),left ventricular endsystolic diameter (LVESD),left ventricular posterior wall depth (LVPWD) and left atrial strain rate during systolic period (SRa) in right ventricle group and left ventricle group were significantly higher than those in control group (P＜005),while left ventricular stroke volume (LVSV),left atrial ejection fraction (LAEF) and left ventricular ejection fraction ( LVEF) were significantly lower than those in control group (P＜005)Compared with those before RFCA,improvement in indexes such as LAD,LAEF,left atrial strain (S),SRa and left atrial strain rate during left ventricular systolic period (SRs) in right ventricle group was better than that in left ventricle group (P＜005)The plasma BNP level in right ventricle group and left ventricle group was significantly higher than that in control groupAfter〖LM〗 RFCA,this level was significantly decreasedAnd the decrease degree in right ventricle group was more significant (P＜005)Conclusion:Frequent PVC of different origins are accompanied with left atrial dysfunction and elevated plasma BNP levelAfter RFCA,the improvement of left atrial function,structure and plasma BNP level in PVC patients of right ventricular origin is better than of left ventricular origin

参考文献/References:

[1] Wojdyta Hordynska A,Kowalski O,Hordynski GJ,et al.The effect of radiofrequency catheter ablation of frequent premature ventricular complexes and arrhythmia burden on left ventricular function[J] .Kardiol Pol,2017,75(7):698704
[2] 王 璇,杜荣增频发室性早搏患者91例的临床症状及心电图特征分析[J] .江苏医药,2016,42(20):22212223
[3] 高连杰美托洛尔联合稳心颗粒对高血压心脏病室性早搏患者的治疗效果和血液流变学分析[J] .实用临床医药杂志,2017,21(1):148149
[4] 魏 颖,张 波,刘 怡,等床旁超声心动图诊断射频消融术后心脏左心室心肌夹层破裂1例[J] .中国介入心脏病学杂志,2016,24(3):171172
[5] Li Y,Lin J,Lin JDynamic changes of QRS morphology of premature ventricular contractions during ablation in the right ventricular outflow tract:a case report[J] .Medicine,2015,94(42):e1885
[6] 李永豪,王卓清,龚积艳,等无创血流动力学检测评价特发性室性期前收缩患者经导管射频消融术前后心功能变化的临床研究[J] .军事医学,2017,41(5):402405
[7] 纪道兵,周心涛,许 浩,等重组人脑钠肽治疗老年急性失代偿期心力衰竭患者的疗效[J] .心血管康复医学杂志,2017,26(4):395398
[8] 侯军龙,魏亚静冷冻球囊消融术与射频消融术治疗心房颤动有效性和安全性的比较研究[J] .实用心脑肺血管病杂志,2016,24(1):111114
[9] 苏广玉频发室性期前收缩所致心肌病患者心功能变化及治疗分析[J] .实用心脑肺血管病杂志,2015,23(4):8284
[10] 郭兰燕,张殿新,程何祥,等经股动脉入径行射频消融后加压包扎时间与并发症相关性研究[J] .中华心律失常学杂志,2017,21(2):141144
[11] Blaauw Y,Pison L,Opstal JM V,et al.Reversal of ventricular premature beat induced cardiomyopathy by radiofrequency catheter ablation[J] .Neth Heart J,2010,18(10):493498
[12] 王劲风,汪祥海,蔚有权,等Carto 3系统指导下导管消融频发性室性早搏的有效性观察[J] .安徽医学,2015,36(10):11941197
[13] 邵 静,刘 磊,宋旭东,等心腔内超声引导下节制束室性早搏消融一例[J] .中国循环杂志,2017,32(z1):6465
[14] Bay M,Kirk V,Parner J,et al.NTproBNP:a new diagnostic screening tool to differentiate between patients with normal and reduced left ventricular systolic function[J] .Heart,2003,89(2):150154
[15] 刘福强,李 岩,谢 勇,等特发性频发室性早搏患者经导管射频消融术后血浆BNP水平变化的临床研究[J] .医学临床研究,2011,28(8):14411443,1446

相似文献/References:

[1]周晚晴,戴 敏,孙娟娟,等.房颤患者射频消融术后血浆微小RNA-21、微小RNA-150水平变化及其检测价值分析[J].陕西医学杂志,2024,(7):970.[doi:DOI:10.3969/j.issn.1000-7377.2024.07.023]
　ZHOU Wanqing,DAI Min,SUN Juanjuan,et al.Changes of plasma miR-21 and miR-150 levels in patients with atrial fibrillation after radiofrequency ablation and their detection value analysis[J].,2024,(12):970.[doi:DOI:10.3969/j.issn.1000-7377.2024.07.023]

备注/Memo

备注/Memo:
*陕西省卫生和计划生育委员会科研项目(2017359KG0241)
更新日期/Last Update: 2019-12-19