高级检索
中华心律失常学杂志
期刊首页
过刊列表
高级检索
稿件发表
• 临床研究 •
ENGLISH ABSTRACT
不同来源频发室性早搏射频消融前后左心房功能变化
张艳
谢瑞芹
白晖
尤玲
尹洪宁
郑红梅
王倩
耿雪
作者及单位信息
·
DOI： 10.3760/cma.j.issn.1007-6638.2017.03.007
Changes of left atrial function after radiofrequency ablation of frequent premature ventricular contractions from different origins
Zhang Yan
Xie Ruiqin
Bai Hui
You Ling
Yin Hongning
Zheng Hongmei
Wang Qian
Geng Xue
Authors Info & Affiliations
Zhang Yan
Department One of Cardiology, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, China.
Xie Ruiqin
Bai Hui
You Ling
Yin Hongning
Zheng Hongmei
Wang Qian
Geng Xue
·
DOI： 10.3760/cma.j.issn.1007-6638.2017.03.007
578
62
0
0
0
0
PDF下载
APP内阅读
摘要

目的通过对比不同来源频发室性早搏(PVC)患者射频消融术前及术后左心房功能，了解成功射频消融术后左心房功能变化及不同起源频发PVC对左心房功能变化的影响，从而指导临床PVC的治疗。

方法收集2014年12月至2015年12月在河北医科大学第二医院住院的24 h PVC负荷>10 000，且成功行射频消融术的患者68例。依据术中不同PVC起源定位分为右心室来源频发PVC患者41例[年龄(47±15)岁，男15例]，左心室来源频发PVC患者27例[年龄(50±17)岁，男16例]。采用二维斑点追踪技术分别于术前、术后1d、2周、4周观察所有入选患者左心房结构和功能指标。分析2组患者各指标组间及组内比较有无差异。

结果右心室来源组：左心房内径(LAD)呈缓慢减小趋势，于术后2周达最低点[(31.7±3.6)mm对(33.2±4.6)mm， P<0.05]；左心房射血分数(LAEF)术前较健康人群显著降低(63.6%±9.3%对70.3%±9.2%， P<0.05)，术后缓慢升高并于术后4周达最高点(68.1%±8.2%对63.6%±9.3%， P<0.05)；左心房应变及左心房收缩期应变率术后4周内逐渐升高( P<0.05)。左心室来源组：LAEF术前较健康人群降低(60.9%±12.2%对70.3%±9.2%， P<0.05)，术后4周内较术前差异无统计学意义；左心房应变术后4周内逐渐升高( P<0.05)。组间比较：左心房应变及左心室舒张早期应变率右心室来源组变化明显优于左心室来源组( P<0.05)，其余各指标虽然右心室来源组变化有优于左心室来源组变化的趋势，但差异无统计学意义( P>0.05)。

结论右心室来源频发PVC射频消融术后4周左心房功能显著改善，而左心室来源频发PVC射频消融术后4周左心房功能无明显改善。提示临床上对于右心室来源的PVC应该更加积极治疗。

室性早搏;射频导管消融;左心房;超声心动图
ABSTRACT

ObjectiveTo evaluate the changes of left atrial function after radiofrequency catheter ablation (RFCA)and the influence of different origin frequent premature ventricular contractions(PVC)on left atrial function before and after RFCA.

MethodsA total of 68 inpatients with frequent PVC observed on 24 h Holter monitoring(>10 000/24 h)and successful radiofrequency ablation were included in this study in the Second Hospital of Hebei Medical University from December 2014 to December 2015.Among them 41 patients with frequent PVC originated from the right ventricle [age(47±15)years, 15 males] and 27 originated from the left ventricle [age(50±17)years, 16 males]. Left atrial structure and function indices were measured by echocardiography before and after RFCA at 1 day, 2 weeks and 4 weeks to investigate whether there was a difference between groups.

ResultsIn the right ventricular PVC group, the left atrium diameter(LAD)showed a little decreasing trend, the LAD at 2 weeks after operation was the lowest level [(31.7±3.6) mm vs.(33.2±4.6) mm, P<0.05]. Preoperative left atrial ejection fraction(LAEF) was significantly lower than that of healthy controls(63.6%±9.3% vs.70.3%±9.2%, P<0.05), postoperative LAEF increased slowly and upped to the highest point in 4 weeks after operation(68.1%±8.2% vs.63.6%±9.3%, P<0.05). The left atrial strain(S)and the strain rate at left atrial systolic(SRa)after radiofrequency ablation increased gradually( P<0.05). In the left ventricular PVC group, preoperative LAEF was significantly lower than that of healthy controls(60.9%±12.2% vs.70.3%±9.2%, P<0.05) and there was no significant difference between before and 4 weeks after radiofrequency ablation( P>0.05). The S and the strain rate at left ventricular diastolic early(SRe)in the right ventricular group was significantly higher than that in the left ventricular group( P<0.05). Although, other indexes had a trend of drcrease in the right ventricular origin group than that in the left ventricular origin group, the differences were not statistically significant( P>0.05).

ConclusionsThe left atrial function was significantly improved in 4 weeks after operation in the right ventricular origin group, but had no change in the left ventricular origin group.We should make more aggressive treatment of frequent PVC originating from the right ventricle.

Premature ventricular contractions;Radiofrequency catheter ablation;Left atrium;Echocardiography
Xie Ruiqin, Email: mocdef.3ab6106087103231
Copyright by Chinese Medical Association
No content published by the journals of Chinese Medical Association may be reproduced or abridged without authorization. Please do not use or copy the layout and design of the journals without permission.
All articles published represent the opinions of the authors, and do not reflect the official policy of the Chinese Medical Association or the Editorial Board, unless this is clearly specified.
引用本文

张艳,谢瑞芹,白晖,等. 不同来源频发室性早搏射频消融前后左心房功能变化[J]. 中华心律失常学杂志,2017,21(3)：213-218.

DOI:10.3760/cma.j.issn.1007-6638.2017.03.007

PERMISSIONS

Request permissions for this article from CCC.

评价本文
*以上评分为匿名评价

版权归中华医学会所有。

未经授权，不得转载、摘编本刊文章，不得使用本刊的版式设计。

除非特别声明，本刊刊出的所有文章不代表中华医学会和本刊编委会的观点。

室性早搏(premature ventricular contractions，PVC)是一种常见的室性心律失常，曾被认为是良性病变 [ 1 ]。然而，近年来研究发现，频发PVC不仅可以引发左心室收缩及舒张功能降低 [ 2 , 3 , 4 ]，还可以引起左心房增大、左心房重构 [ 5 ]，严重影响人们健康。
研究显示射频导管消融(RFCA)成功治疗频发PVC后可使患者心室收缩及舒张功能得到显著改善 [ 6 ]。近期Akkaya等 [ 7 ]针对频发PVC RFCA术后左心房容积变化的研究指出，RFCA术后患者左心房容积较术前明显减小，逆向改善左心房重构。但对于成功消融后4周内不同来源频发PVC左心房结构及功能是否变化、变化趋势是否不同则尚无明确说明。
试读结束，您可以通过登录机构账户或个人账户后获取全文阅读权限。
参考文献
[1]
Gaita F , Giustetto C , Di Donna P ，et al. Long-term follow-up of right ventricular monomorphic extrasystoles[J]．J Am Coll Cardiol， 2001，38(2):364-370. DOI： 10.1016/S0735-1097(01)01403-6 .
返回引文位置Google Scholar
百度学术
万方数据
[2]
Huizar JF , Kaszala K , Potfay J ，et al. Left ventricular systolic dysfunction induced by ventricular ectopy: a novel model for premature ventricular contraction-induced cardiomyopathy[J]．Circ Arrhyth Electrophysiol， 2011，4(4),543-549. DOI： 10.1161/CIRCEP.111.962381 .
返回引文位置Google Scholar
百度学术
万方数据
[3]
Yarlagadda RK , Iwai S , Stein KM ，et al. Reversal of cardiomyopathy in patients with repetitive monomorphic ventricular ectopy originating from the right ventricular outflow tract[J]．Circulation， 2005，112(8):1092-1097. DOI: 10.1161/CIRCULATIONAHA.105.546432 .
返回引文位置Google Scholar
百度学术
万方数据
[4]
Bogun F , Crawford T , Reich S ，et al. Radiofrequency ablation of frequent，idiopathic premature ventricular complexes: comparison with a control group without intervention[J]．Heart Rhythm， 2007，4(7):863-867. DOI: 10.1016/j.hrthm.2007.03.003 .
返回引文位置Google Scholar
百度学术
万方数据
[5]
Park Y , Kim S , Shin J ，et al. Frequent premature ventricular complex is associated with left atrial enl argement in patients with normal left ventricular ejection fraction [J]．Pacing Clin Electrophysiol， 2014，37(11):1455-1461. DOI: 10.1111/pace.12447 .
返回引文位置Google Scholar
百度学术
万方数据
[6]
Kadri M , Yokokawa M , Labounty T ，et al. Effect of ablation of frequent premature ventricular complexes on left ventricular function in patients with nonischemic cardiomyopathy[J]．Heart Rhythm， 2015，12(4):706-713. DOI: 10.1016/j.hrthm.2014.12.017 .
返回引文位置Google Scholar
百度学术
万方数据
[7]
Akkaya M , Roukoz H , Adabag S ，et al. Improvement of left ventricular diastolic function and left atrial reverse remodeling after catheter ablation of premature ventricular complexes[J]．J Interv Card Electrophysiol， 2013，38(3):179-185. DOI： 10.1007/s10840-013-9836-0 .
返回引文位置Google Scholar
百度学术
万方数据
[8]
Saraiva RM , Demirkol S , Buakhamsri A ，et al. Left atrial strain measured by two-dimensional speckle tracking represents a new tool to evaluate left atrial function[J]．J Am Soc Echocardiogr， 2010，23(2):172-180. DOI: 10.1016/j.echo.2009.11.003 .
返回引文位置Google Scholar
百度学术
万方数据
[9]
Abhayaratna WP , Seward JB , Appleton CP ，et al. Left atrial size: physiologic determinants and clinical applications[J]．J Am Coll Cardiol， 2006，47(12):2357-2363. DOI: 10.1016/j.jacc.2006.02.048 .
返回引文位置Google Scholar
百度学术
万方数据
[10]
Moon J , Shim CY , Ha JW ，et al. Clinical and echocardiographic predictors of outcomes in patients with apical hypertrophic cardiomyopathy[J]．Am J Cardiol， 2011，108(11):1614-1619. DOI: 10.1016/j.amjcard.2011.07.024 .
返回引文位置Google Scholar
百度学术
万方数据
[11]
Laukkanen JA , Kurl S , Eränen J ，et al. Left atrium size and the risk of cardiovascular death in middle-aged men[J]．Arch Intern Med， 2005，165(15):1788-1793. DOI: 10.1001/archinte.165.15.1788 .
返回引文位置Google Scholar
百度学术
万方数据
[12]
Pritchett AM , Mahoney DW , Jacobsen SJ ，et al. Diastolic dysfunction and left atrial volume: a population-based study[J]．J Am Coll Cardiol， 2005，45(1):87-92. DOI: 10.1016/j.jacc.2004.09.054 .
返回引文位置Google Scholar
百度学术
万方数据
[13]
Sarrazin JF , Labounty T , Kuhne M ，et al. Impact of radiofrequency ablation of frequent post-infarction premature ventricular complexes on left ventricular ejection fraction[J]．Heart Rhythm， 2009，6(11):1543-1549. DOI: 10.1016/j.hrthm.2009.08.004 .
返回引文位置Google Scholar
百度学术
万方数据
[14]
Takemoto M , Yoshimura H , Ohba Y ，et al. Radiofrequency catheter ablation of premature ventricular complexes from right ventricular outflow tract improves left ventricular dilation and clinical status in patients without structural heart disease[J]．J Am Coll Cardiol， 2005，45(8):1259-1265. DOI: 10.1016/j.jacc.2004.12.073 .
返回引文位置Google Scholar
百度学术
万方数据
[15]
Taieb JM , Maury P , Shah D ，et al. Reversal of dilated cardiomyopathy by the elimination of frequent left or right premature ventricular contractions[J]．J Interv Card Electrophysiol， 2007，20(1-2):9-13. DOI: 10.1007/s10840-007-9157-2 .
返回引文位置Google Scholar
百度学术
万方数据
[16]
Baman TS , Lange DC , Ilg KJ ，et al. Relationship between burden of premature ventricular complexes and left ventricular function[J]．Heart Rhythm， 2010，7(7):865-869. DOI: 10.1016/j.hrthm.2010.03.036 .
返回引文位置Google Scholar
百度学术
万方数据
[17]
Sekiguchi Y , Aonuma K , Yamauchi Y ，et al. Chronic hemodynamic effects after radiofrequency catheter ablation of frequent monomorphic ventricular premature beats[J]．J Cardiovasc Electrophysiol， 2005，16(10):1057-1063. DOI： 10.1111/j.1540-8167.2005.40786.x .
返回引文位置Google Scholar
百度学术
万方数据
[18]
Wijnmaalen AP , Delgado V , Schalij MJ ，et al. Beneficial effec ts of catheter ablation on left ventricular and right ventricular function in patients with frequent premature ventricular contractions and preserved ejection fraction [J]．Heart， 2010，96(16):1275-1280. DOI: 10.1136/hrt.2009.188722 .
返回引文位置Google Scholar
百度学术
万方数据
[19]
Del Carpio Munoz F , Syed FF , Noheria A ，et al. Characteristics of premature ventricular complexes as correlates of reduced left ventricular systolic function: study of the burden，duration，coupling interval，morphology and site of origin of PVCs[J]．J Cardiovasc Electrophysiol， 2011，22(7):791-798. DOI: 10.1111/j.1540-8167.2011.02021.x .
返回引文位置Google Scholar
百度学术
万方数据
[20]
Saraiva RM , Demirkol S , Buakhamsri A ，et al. Left a trial strain measured by two-dimensional speckle tracking represents a new tool to evaluate left atrial function [J]．J Am Soc Echocardiogr， 2010，23(2):172-180. DOI: 10.1016/j.echo.2009.11.003 .
返回引文位置Google Scholar
百度学术
万方数据
[21]
Cameli M , Lisi M , Righini FM ，et al. Novel echocardiographic techniques to assess left atrial size，anatomy and function[J]．Cardiovasc Ultrasound， 2012，10(1):4. DOI: 10.1186/1476-7120-10-4 .
返回引文位置Google Scholar
百度学术
万方数据
备注信息
A
谢瑞芹，Email： mocdef.3ab6106087103231
B
无
评论 （0条）
注册
登录
时间排序
暂无评论，发表第一条评论抢沙发
最新推荐
更多
应用四维自动左心房量化技术评价不同年龄段成人左心房功能研究
徐涛 等
中华老年医学杂志 2024,43(08)
实时三维超声心动图评估肥厚型心肌病突变基因携带者左心房结构与功能变化特点研究
梁青青 等
中国全科医学 2024,27(24)
D-二聚体及左心房前后径联合CHA2DS2-VASc评分排除非瓣膜性心房颤动患者左心房血栓的价值
吴寸草 等
中华医学杂志 2021,101(48)
左心房大小对磁导航指导下心房颤动射频消融的影响
刘晓宇 等
中华心律失常学杂志 2019,23(01)
MedAI助手（体验版）
文档即答
智问智答
机器翻译
回答内容由人工智能生成，我社无法保证其准确性和完整性，该生成内容不代表我们的态度或观点，仅供参考。
生成快照
文献快照

你好，我可以帮助您更好的了解本文，请向我提问您关注的问题。

0/2000

《中华医学会杂志社用户协议》 | 《隐私政策》

《SparkDesk 用户协议》 | 《SparkDesk 隐私政策》

网信算备340104764864601230055号 | 网信算备340104726288401230013号

技术支持：

历史对话
本文全部
还没有聊天记录
设置
模式
纯净模式沉浸模式
字号
小中大