射频导管消融后左室收缩和舒张功能的序贯评价。

Abdurrahman Eksik, Sevket Gorgulu, Mehmet Eren, Ahmet Akyol, Izzet Erdinler, Enis Oguz, Kadir Gurkan, Tanju Ulufer, Tuna Tezel
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引用次数: 8

摘要

射频(RF)导管消融已成为许多类型心律失常的标准治疗方法。射频能量可通过损伤心肌引起左心室功能恶化。本研究的目的是利用各种超声心动图参数评估导管消融后左心室功能的变化。40例患者(22名女性),年龄37 +/- 14岁(范围15-76岁),因各种心动过速行导管消融。所有患者均行常规超声心动图检查。采用改良Simpson法和组织多普勒法评价左心室收缩功能。在左室舒张功能参数方面,评估舒张早期(E)和晚期(A)递质充盈速度、减速时间(DT)、等容松弛时间(IVRT)和组织多普勒参数。在消融前、消融后1小时、1天和1个月评估所有心室功能参数。为避免心率对舒张功能参数的影响,将E/A比、DT、IVRT调整为心率(cE/A、cDT、cIVRT)。消融后左心室收缩功能未见明显变化。消融后(1小时、1天和1个月),cE/A比值分别从1.42 +/- 0.43降至1.19 +/- 0.40、1.18 +/- 0.40和1.30 +/- 0.33 (P = 0.009)。cDT分别从210 +/- 54增加到272 +/- 64、255 +/- 60、240 +/- 64 (P = 0.001)。同样,cIVRT也从113 +/- 22增加到133 +/- 54、123 +/- 27、117 +/- 19 (P = 0.007)。在评估舒张功能时也观察到组织多普勒参数的显著变化。虽然射频消融后未观察到收缩功能的显著变化,但该手术可能对心室舒张功能参数有一些不利影响。
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Sequential evaluation of left ventricular systolic and diastolic function after radiofrequency catheter ablation.

Radiofrequency (RF) catheter ablation has become standard therapy for many types of arrhythmias. RF energy may cause deterioration in left ventricular function by damaging the myocardium. The aim of the present study was to assess the changes in left ventricular function after catheter ablation using various echocardiographic parameters. Forty patients (22 women), aged 37 +/- 14 years (range, 15-76 years), underwent catheter ablation for various tachycardias. Routine echocardiogaphic examination was done in all patients. Left ventricular systolic function was evaluated by the modified Simpson method and tissue Doppler. With regard to left ventricular diastolic function parameters, diastolic early (E) and late (A) transmitral filling velocities, deceleration time (DT), isovolumetric relaxation time (IVRT), and tissue Doppler parameters were assessed. All ventricular function parameters were assessed before, and 1 hour, 1 day, and 1 month after the catheter ablation procedure. To avoid any influence of heart rate on diastolic function parameters, the E/A ratio, DT, and IVRT were adjusted to heart rate (cE/A, cDT, cIVRT). No changes in left ventricular systolic function after the ablation were observed. After the ablation procedure (1 hour, 1 day, and 1 month) the cE/A ratio decreased from 1.42 +/- 0.43 to 1.19 +/- 0.40, 1.18 +/- 0.40, and 1.30 +/- 0.33 (P = 0.009), respectively. cDT increased from 210 +/- 54 to 272 +/- 64, 255 +/- 60, 240 +/- 64 (P = 0.001), respectively. Likewise cIVRT increased from 113 +/- 22 to 133 +/- 54, 123 +/- 27, 117 +/- 19 (P = 0.007), respectively. Significant changes were also observed concerning tissue Doppler parameters in assessing diastolic function. Although no significant changes were observed in systolic function after RF ablation, this procedure may have some detrimental effects on ventricular diastolic function para-meters.

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