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目的观察不同房室延迟(AVD)的双腔起搏对心脏收缩、舒张功能的影响及不同心功能状态下的优化AVD。方法测量20例心力衰竭患者及10例心功能正常者(对照组)不同房室延迟起搏的急性血流动力学效应,同时以脉冲多普勒超声心动描记术测量心脏收缩、舒张功能指标。结果心力衰竭组房室延迟在134±13、131±12、136±10ms起搏时,血流动力学指标及左心室收缩功能、右心室舒张功能指标较AVD基线穴100ms雪及250ms显著改善;140±17ms起搏时,左心室舒张功能指标较AVD基线及250ms显著改善。对照组AVD在162±14ms起搏时,血流动力学参数较AVD基线及250ms显著改善。结论优化AVD可即刻改善心力衰竭患者心脏收缩及舒张功能,优化AVD随心功能状态不同而改变。
Objective To observe the effect of double chamber pacing with different atrioventricular delay (AVD) on cardiac systolic and diastolic function and optimize AVD under different cardiac function states. Methods The acute hemodynamic effects of delayed ventricular pacing in 20 patients with heart failure and 10 patients with normal heart function (control group) were measured. The indexes of cardiac systolic and diastolic function were measured by pulsed Doppler echocardiography. Results After atrial tachycardia (134 ± 13,131 ± 12,136 ± 10ms) pacing in heart failure group, hemodynamics, left ventricular systolic function and right ventricular diastolic function were significantly improved compared with 100ms snow and 250ms AVD baseline. 140 ± 17ms pacing, left ventricular diastolic function index compared with the AVD baseline and 250ms significantly improved. At 162 ± 14 ms pacing in control AVD, hemodynamic parameters were significantly improved over AVD baseline and 250 ms. Conclusion Optimization of AVD can immediately improve cardiac contractility and diastolic function in patients with heart failure, and optimize the AVD to change with different cardiac function states.