双心腔起搏治疗肥厚性梗阻型心肌病血液动力学观察(摘要)
作者：华伟 王方正 杨跃进 张奎俊 余培贞 王锦志 李一石 马坚 孙瑞龙 陈新
单位：北京市，中国医学科学院 中国协和医科大学 心血管病研究所 阜外心血管病医院 临床电生理研究室(100037)
关键词：
中国循环杂志99zk115 目的：双心腔起搏治疗肥厚性梗阻型心肌病是近年来用于临床的新治疗方法，本文应用此治疗方法治疗了23例患者并观察了其血液动力学效果。
方法：23例患者，男16例，女7例，平均年龄39岁，均确诊为肥厚性梗阻型心肌病，所有患者均有头晕、活动后气短等临床症状，其中12例患者有晕厥发生，超声心动图检查，平均心室间隔厚度为2.1 cm,左心室流出道压力差平均为51.05 mmHg(1 mmHg=0.133 kPa)。
结果：所有患者均置入了双心腔起搏器，在以较短的房室间期(100 ms)进行双心腔起搏后，左心室流出道压力差从51.05 mmHg下降至19.07 mmHg(P<0.05),患者临床症状明显改善，在平均随访9个月中(5～23月)无一例患者发生晕厥。
结论：双心腔起搏治疗肥厚性梗阻型心肌病是一种有效的新的治疗方法，临床应用时注意选择合适的起搏参数。
Hemodynamic Assessment of Dual-Chamber Pacing in Patients with Hypertrophic Obstructive Cardiomyopathy (Abstract)
Department of Clinical Electrophysiology, Cardiovascular Institute and Fu Wai Hospital, CAMS and PUMC, Beijing (100037)
Hua Wei, Wang Fangzheng, Yang Yuejing, et al.
Objective: We report our clinical use of dual-chamber pacing in patients with hypertrophic obstructive cardiomyopathy (HOCM) and its hemodynamic effects.
Methods: Twenty-three patients, 16 males and 7 females, mean age of 39 years, with HOCM, were implanted permanent dual-chamber pacemaker. All patients had clinical symptoms refractory to medical therapy (β blockers and/or Ca2+ blockers) and 12 of them had syncope. Mean thickeness of the ventricular septum was 2.1 cm.
Results: The symptoms were significantly improved in 20 patients after pacing with short A-V delay compared to those before pacing. The left ventricular outfolw tract (LVOT) pressure gradients were reduced from 51.05 to 19.07 mmHg after pacing (p<0.05). In a follow-up of 9 months (5～23 months), no patients had syncope.
Conclusion: Dual-chamber pacing is an effective new method to treat patients with HOCM., 百拇医药
单位：北京市，中国医学科学院 中国协和医科大学 心血管病研究所 阜外心血管病医院 临床电生理研究室(100037)
关键词：
中国循环杂志99zk115 目的：双心腔起搏治疗肥厚性梗阻型心肌病是近年来用于临床的新治疗方法，本文应用此治疗方法治疗了23例患者并观察了其血液动力学效果。
方法：23例患者，男16例，女7例，平均年龄39岁，均确诊为肥厚性梗阻型心肌病，所有患者均有头晕、活动后气短等临床症状，其中12例患者有晕厥发生，超声心动图检查，平均心室间隔厚度为2.1 cm,左心室流出道压力差平均为51.05 mmHg(1 mmHg=0.133 kPa)。
结果：所有患者均置入了双心腔起搏器，在以较短的房室间期(100 ms)进行双心腔起搏后，左心室流出道压力差从51.05 mmHg下降至19.07 mmHg(P<0.05),患者临床症状明显改善，在平均随访9个月中(5～23月)无一例患者发生晕厥。
结论：双心腔起搏治疗肥厚性梗阻型心肌病是一种有效的新的治疗方法，临床应用时注意选择合适的起搏参数。
Hemodynamic Assessment of Dual-Chamber Pacing in Patients with Hypertrophic Obstructive Cardiomyopathy (Abstract)
Department of Clinical Electrophysiology, Cardiovascular Institute and Fu Wai Hospital, CAMS and PUMC, Beijing (100037)
Hua Wei, Wang Fangzheng, Yang Yuejing, et al.
Objective: We report our clinical use of dual-chamber pacing in patients with hypertrophic obstructive cardiomyopathy (HOCM) and its hemodynamic effects.
Methods: Twenty-three patients, 16 males and 7 females, mean age of 39 years, with HOCM, were implanted permanent dual-chamber pacemaker. All patients had clinical symptoms refractory to medical therapy (β blockers and/or Ca2+ blockers) and 12 of them had syncope. Mean thickeness of the ventricular septum was 2.1 cm.
Results: The symptoms were significantly improved in 20 patients after pacing with short A-V delay compared to those before pacing. The left ventricular outfolw tract (LVOT) pressure gradients were reduced from 51.05 to 19.07 mmHg after pacing (p<0.05). In a follow-up of 9 months (5～23 months), no patients had syncope.
Conclusion: Dual-chamber pacing is an effective new method to treat patients with HOCM., 百拇医药