Dohi Kaoru, Suffoletto Matthew, Murali Srinivas, Bazaz Raveen, Gorcsan John
University of Pittsburgh, Scaife 564, 200 Lothrop Street, Pittsburgh, PA 15213-2582, USA.
Eur J Echocardiogr. 2005 Dec;6(6):455-60. doi: 10.1016/j.euje.2005.02.001. Epub 2005 Apr 2.
This report described an 81-year-old woman with severe symptomatic heart failure, reduced ejection fraction, mitral regurgitation, and an electrocardiographic QRS width of 118 ms who had ventricular dyssynchrony identified by echocardiographic tissue synchronization imaging. Because of her severe heart failure symptoms on maximal medical therapy, referral to implant a defibrillator, and mechanical dyssynchrony, she underwent cardiac resynchronization-defibrillator therapy with lateral left ventricular lead placement. This resulted in an immediate 30% increase in stroke volume and 35% decrease in mitral regurgitation. Echocardiographic tissue synchronization imaging may play a role in identifying mechanical dyssynchrony in patients with narrow QRS duration who may potentially benefit from cardiac resynchronization therapy.
本报告描述了一名81岁女性，患有严重症状性心力衰竭、射血分数降低、二尖瓣反流，心电图QRS波宽度为118毫秒，经超声心动图组织同步成像确定存在心室不同步。由于她在最大药物治疗下仍有严重心力衰竭症状、被转诊植入除颤器以及存在机械不同步，她接受了左心室侧方导联置入的心脏再同步化除颤器治疗。这导致每搏输出量立即增加30%，二尖瓣反流减少35%。超声心动图组织同步成像可能在识别QRS波时限狭窄且可能从心脏再同步化治疗中获益的患者的机械不同步方面发挥作用。
