非吸烟患者不同起搏模式对中心动脉压和动脉波增强指数的影响及意义

摘要

Objective To investigate the influence and clinical significance of single and dual-chamber pacing on central aortic pressure (CAP) and augmentation index (AI) in non-smoking individuals. Methods Totally, 83 non-smokers with pacemaker-implanted were consecutively enrolled in this study, and they were divided into three groups:dual-chamber pacemaker group (DDD, n=35), single-chamber pacemaker group (VVI, n=33) and control group (n=15). Heart rate (HR), CAP, AI, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured in three groups of patients. Finally, DDD pacing mode was turned into VVI pacing mode in patients of DDD group and the indexes were measured again. All of the indexes were recorded and analyzed. Results There were no significant changes in baseline characteristics and laboratory data between three groups (P>0.05). Left atrial diameters were significantly higher in VVI group than those of control group (P<0.05). Values of CAP were significantly higher in DDD group than those of control group and VVI group (P<0.05). Values of AI, corrected AI (AIc) and brachial BP were significantly higher in DDD group than those of VVI group (P<0.05). Values of CAP and brachial BP were significantly lower in VVI group than those of control group (P<0.05), while no significant changes were found in AI and AIC between VVI group and control group (P>0.05). All of these indexes (CAP, AI and brachial BP) were significantly reduced after the pacing mode was changed (P<0.05). Conclusion In non-smokers, dual-chamber pacing mode can increase CAP and AI.%目的：探讨非吸烟患者单腔和双腔起搏对中心动脉压（CAP）和动脉波增强指数（AI）的影响及临床意义。方法入选因缓慢性心律失常入院并植入起搏器的非吸烟患者83例，并将其分为双腔起搏器患者35例（DDD组），单腔起搏器患者33例（VVI组），术后正常窦性心律者15例（对照组），分别测量3组患者的心率（HR）、CAP、AI、外周收缩压（SBP）、外周舒张压（DBP）等指标，然后对DDD组患者的起搏器进行程控，将DDD模式程控成VVI模式，待患者心率稳定后测量以上指标。结果3组患者一般情况和实验室指标比较差异均无统计学意义。VVI组左心房直径大于对照组（P＜0.05）；DDD组CAP明显高于对照组和VVI组（P＜0.05）；DDD组AI、校正AI（AIC）和外周血压均高于VVI组（P＜0.05）；VVI组CAP和外周血压明显低于对照组（P＜0.05），而对于AI和AIC与对照组比较差异无统计学意义；DDD组程控后的CAP、AI和外周动脉血压水平均低于程控前（P＜0.05）。结论在非吸烟患者中双腔起搏模式会明显升高CAP和AI。