超声心动图对高龄心力衰竭患者心脏再同步治疗效果的评估价值及其分析

摘要

Objective To observe and analyze the assessment value of echocardiography for elderly patients with heart failure who underwent cardiac resynchronization therapy. Methods The retrospective analysis of 57 chronic heart failure patients who were successfully implanted with CRT was conducted. The echocardiography data, clinical data, surgical data and postoperative 1,3,6 months of follow-up, clinical symptoms before and after the surgery, electrocardiogram QRS duration, surgical complications and survival condition were collected and analyzed. Results Compared with preoperative LVEF, postoperative LVEF increased by (8.1±1.6)%, P=0.34; compared with preoperative LVEDD, postoperative LVEDD increased by (-6.5 ±1.2)mm, P=0.441; compared with preoperative NYHA, postopera-tive NYHA decreased by 0.82±0.78, P=0.63; compared with preoperative 6 MWD, postoperative 6MWD increased (50.1±29.3)m; P=0.53; compared with preoperative QRS duration, postoperative QRS duration decreased (4.6±0.3)ms;P=0.10. The LVEF and LVEDD change before and after CRT were significantly correlated with NYHA heart function classification, 6 MWD, as well as the change of QRS duration. Conclusion The present study suggests echocardiog-raphy for elderly heart failure patients with cardiac resynchronization therapy is of great value in evaluation. It is worth to be promoted in clinic.%目的：观察和分析超声心动图对高龄心力衰竭患者心脏再同步治疗（CRT）效果的评估价值。方法回顾性分析我院57例成功植入CRT的慢性心力衰竭患者，收集患者手术前后的超声心动图资料，并与临床资料、手术资料及术后1、3、6个月的随访资料，对手术前后临床症状，心电图QRS时限，手术并发症及生存状况进行分析，从而对超声心动图对于高龄心力衰竭患者CRT效果的评估价值进行分析。结果左心室射血分数（LVEF）较术前增加了（8．1±1．6）％，P＝0．34，左心室舒张末期内径（LVEDD）分别较术前下降了（-6．5±1．2）mm，P＝0．441；纽约心脏病协会（NYHA）心功能分级分别较术前降低（0．82±0．78，P＝0．63，6 min步行距离（6MWD）分别较术前提高了（50．1±29．3）m，P＝0．53，QRS时限较术前减少了（4．6±0．3）ms，P＝0．16。手术前后的LVEF和LVEDD改变与NYHA心功能分级、6MWD、以及QRS时限的改变具有高度的相关性。结论本研究提示超声心动图对于高龄心力衰竭患者心脏再同步的治疗效果具有极高的评估价值，值得在临床大力推广应用。