Yonekura Tsuyoshi, Toda Genji, Furudono Shinnosuke, Minami Takako, Kawano Hiroaki, Koide Yuji, Yano Katsusuke
Department of Cardiovascular Medicine, Course of Medical and Dental Sciences, Graduate School of Biomedical Sciences, Nagasaki University School of Medicine, 1-7-1 Sakamoto-cho, Nagasaki 852-8501.
Intern Med. 2003 Nov;42(11):1107-11. doi: 10.2169/internalmedicine.42.1107.
We report a 75-year-old man with ischemic cardiomyopathy who had mitral regurgitation which was increased markedly by intermittent left bundle branch block (LBBB). He complained of angina-like chest pain that was preceded by episodes of LBBB. During LBBB, a marked elevation of the V wave in the pulmonary capillary wedge pressure was shown, and an increase in mitral and tricuspid regurgitation was observed with color Doppler echocardiography. Biventricular pacing (BVP) therapy was selected so as to protect the patient from episodes of LBBB. After BVP, the patient did not experience chest pain or dyspnea. This case sheds valuable light on the ongoing investigation of the hemodynamic benefit of BVP.
我们报告一例75岁患有缺血性心肌病的男性患者，其存在二尖瓣反流，间歇性左束支传导阻滞（LBBB）可使其显著加重。他主诉在LBBB发作之前出现类似心绞痛的胸痛。在LBBB期间，肺毛细血管楔压的V波显著升高，彩色多普勒超声心动图显示二尖瓣和三尖瓣反流增加。选择双心室起搏（BVP）治疗以保护患者免受LBBB发作的影响。BVP治疗后，患者未再出现胸痛或呼吸困难。该病例为正在进行的BVP血流动力学益处研究提供了有价值的线索。
