Doughan Abdul R, McConnell Michael E, Lyle Teresa A, Book Wendy M
Adult Congenital Cardiac Program, Emory University Hospital School of Medicine, Atlanta, Georgia 30303, USA.
Am J Cardiol. 2005 Jun 15;95(12):1511-4. doi: 10.1016/j.amjcard.2005.01.100.
This study evaluated the effects of pulmonary valve replacement (PVR) on QRS duration and right ventricular (RV) cavity size in patients who had severe pulmonary regurgitation late after previous repair of RV outflow tract obstruction. A significant decrease in maximal QRS duration and RV end-diastolic volume was found after PVR. The change in QRS duration was most significant in patients with a baseline QRS > or =155 ms (176 +/- 15 to 160 +/- 18 ms, p <0.001). RV end-diastolic volume was significantly correlated with maximal QRS duration before (r = 0.93, p <0.0001) as well as after (r = 0.82, p <0.001) PVR. In patients with pulmonary regurgitation late after repair of RV outflow tract obstruction, PVR reduces maximal QRS duration with a concomitant decrease in RV volumes.
本研究评估了肺动脉瓣置换术(PVR)对既往右心室流出道梗阻修复术后晚期出现严重肺动脉反流患者的QRS时限及右心室(RV)腔大小的影响。肺动脉瓣置换术后发现最大QRS时限及右心室舒张末期容积显著降低。对于基线QRS≥155 ms的患者,QRS时限变化最为显著(从176±15 ms降至160±18 ms,p<0.001)。右心室舒张末期容积与肺动脉瓣置换术前(r = 0.93,p<0.0001)及术后(r = 0.82,p<0.001)的最大QRS时限均显著相关。在右心室流出道梗阻修复术后晚期出现肺动脉反流的患者中,肺动脉瓣置换术可缩短最大QRS时限,并同时减少右心室容积。