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目的联合心脏超声及无创血流动力学检测技术探讨频发室性期前收缩(PVC)患者经导管射频消融术(RFCA)前后心功能变化。方法选取48例特发性频发PVC患者为试验组,PVC总数(16 391.03±10 873.01)个/24 h,另外随机选取55例健康查体者为对照组,分别行心脏超声及无创血流动力学检测。同时选试验组中25例患者行RFCA治疗,于术后3 d行无创血流动力学检测。分别比较两组心脏超声及无创血流动力学检测结果,及RFCA前、后3 d无创血流动力学检测结果。结果所有超声结果均无统计学差异。比较PVC组与对照组的无创血流动力学检测结果,PVC组中心缩力指数(HI)、心搏指数(SI)、心脏指数(CI)、室缩波波幅(C)较对照组降低,差异具有统计学意义(P<0.05),而房缩波波幅(WA)、室舒波波幅(O)、左室顺应性指数(WA/C)、舒张功能指数(O/C)较对照组升高,差异具有统计学意义(P<0.01);比较RFCA术前与术后3 d患者无创血流动力学检测结果,术后3 d患者HI、SI、CI、C水平显著升高(P<0.01),而WA、O、WA/C、O/C较术前降低,差异具有统计学意义。结论特发性PVC患者在病程早期其心功能可能已受损,经RFCA可逆转或防止患者因频发PVC而损及心功能。
Objective To investigate the changes of cardiac function before and after catheter radiofrequency ablation (RFCA) in patients with frequent ventricular premature ventricular contractions (PVC) by combined echocardiography and noninvasive hemodynamic testing. Methods 48 patients with idiopathic PVC were selected as the experimental group. The total number of PVC was (16 391.03 ± 10 873.01) / 24 h. In addition, 55 healthy volunteers were randomly selected as the control group. Cardiac ultrasonography and noninvasive blood flow Kinetic testing. At the same time, 25 patients in the test group were treated with RFCA. Noninvasive hemodynamic tests were performed on the 3rd postoperative day. The echocardiographic and noninvasive hemodynamic test results were compared between the two groups, and the results of noninvasive hemodynamic tests at 3 days before and after RFCA were compared. Results All ultrasound results were not statistically different. Compared non-invasive hemodynamic test results of PVC group and control group, the central contractive index (HI), cardiac index (SI), cardiac index (CI) and ventricular contractile amplitude (C) (P <0.05), while the amplitude of WA (WA), ambulatory wave amplitude (O), left ventricular compliance index (WA / C) and diastolic function index (O / C) (P <0.01). Compared with noninvasive hemodynamic test before and 3 days after RFCA, the levels of HI, SI, CI and C were significantly increased 3 days after operation (P <0.01), while WA, O, WA / C and O / C decreased compared with that before operation, the difference was statistically significant. CONCLUSIONS: Idiopathic PVC patients may have impaired cardiac function early in the course of their disease and may reverse or prevent patients from impairing heart function due to frequent PVC.