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目的观察顽固性充血性心力衰竭(CHF)患者心脏再同步化治疗(CRT)术后QRS波时限改变及其对左心功能的影响。方法 60例患者接受CRT术,心功能(NYHA分级)Ⅲ～Ⅳ级,左室射血分数(LVEF)11%～35%(27.15±6.35%),左室舒张末期内径(LVEDd)60～106mm(75.35±11.01mm),QRS波时限110～190ms(139.17±23.69ms)。观察术后QRS波时限改变以及对其左心功能的影响。结果术后QRS波时限从139.17±23.69ms缩短至术后124.08±16.91ms,缩短15.42±28.90ms;左心功能从术前3.5±0.5级改善为术后1周2.5±0.5级,平均改善1.0±0.5级。CRT术前QRS波时限与术后左心功能分级改善值不相关,r≈0;而CRT术前后QRS波时限缩短值与术后左心功能(NYHA分级)改善值二组数据均呈不全正相关,r=0.148。结论 CRT术后QRS波时限与心功能均有明显改善,术前QRS波时限不能预测术后心功能改善状况,而CRT术前后QRS波时限缩短值对术后左心功能(NYHA分级)改善有一定预测价值。
Objective To observe the changes of QRS duration after cardiac resynchronization therapy (CRT) and its effect on left ventricular function in patients with refractory congestive heart failure (CHF). Methods 60 patients underwent CRT, NYHA class Ⅲ ~ Ⅳ, left ventricular ejection fraction (LVEF) of 11% -35% (27.15 ± 6.35%), left ventricular end-diastolic dimension (LVEDd) (75.35 ± 11.01mm), QRS wave duration 110 ~ 190ms (139.17 ± 23.69ms). To observe the change of postoperative QRS wave duration and its effect on left ventricular function. Results The duration of postoperative QRS wave was shortened from 139.17 ± 23.69ms to 124.08 ± 16.91ms and shortened 15.42 ± 28.90ms respectively. The left ventricular function improved from 3.5 ± 0.5 before surgery to 2.5 ± 0.5 after 1 week, with an average improvement of 1.0 ± 0.5 level. CRT preoperative QRS wave time limit was not correlated with postoperative improvement of left heart function classification, r ≈ 0; and CRT before and after QRS wave shortening value and postoperative left ventricular function (NYHA classification) improved two sets of data were incomplete Positive correlation, r = 0.148. Conclusion The duration of QRS and cardiac function after CRT were significantly improved. The duration of preoperative QRS wave can not predict the improvement of postoperative cardiac function. However, the shortening of QRS wave before and after CRT can improve the left ventricular function (NYHA class) Have a certain predictive value.