Kurita Tairo, Onishi Katsuya, Dohi Kaoru, Tanabe Masaki, Fujimoto Naoki, Tanigawa Takashi, Setsuda Morimichi, Isaka Naoki, Nobori Tsutomu, Ito Masaaki
Department of Cardiology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu 514-8507, Japan.
Eur J Heart Fail. 2007 Jun-Jul;9(6-7):637-43. doi: 10.1016/j.ejheart.2007.03.002. Epub 2007 Apr 27.
The quantification of mechanical dyssynchrony has important diagnostic value and may help to determine optimal therapy in heart failure (HF). We hypothesized that mechanical dyssynchrony may be augmented at increased heart rates in patients with HF and normal QRS duration.
From online segmental conductance catheter signals, we derived indices to quantify temporal and spatial aspects of mechanical dyssynchrony during systole in 20 control subjects, 20 HF patients with normal QRS duration, and 12 HF patients with complete left bundle branch block (CLBBB). Data were collected at baseline, and then following a 40 bpm increase in heart rate induced by right atrial pacing. Mechanical dyssynchrony in HF patients with normal QRS duration or CLBBB was higher than that found in control subjects. In HF patients with normal QRS duration, mechanical dyssynchrony increased from 37.4+/-4.8% at baseline to 43.2+/-4.4% with increased heart rate (p<0.01), the resultant degree of mechanical dyssynchrony was similar to that at baseline in the HF patients with CLBBB. Increased heart rate did not affect dyssynchrony in the control patients.
Mechanical dyssynchrony was augmented as heart rate increased by right atrial pacing in patients with HF and normal QRS duration.
机械性不同步的量化具有重要的诊断价值，可能有助于确定心力衰竭（HF）的最佳治疗方案。我们假设在QRS时限正常的HF患者中，心率增加时机械性不同步可能会加剧。
我们从在线节段性电导导管信号中得出指标，以量化20名对照受试者、20名QRS时限正常的HF患者和12名完全性左束支传导阻滞（CLBBB）的HF患者在收缩期机械性不同步的时间和空间方面。在基线时收集数据，然后在右心房起搏导致心率增加40次/分钟后再次收集数据。QRS时限正常或CLBBB的HF患者的机械性不同步高于对照受试者。在QRS时限正常的HF患者中，机械性不同步从基线时的37.4±4.8%增加到心率增加时的43.2±4.4%（p<0.01），由此产生的机械性不同步程度与CLBBB的HF患者基线时相似。心率增加对对照患者的不同步没有影响。
在QRS时限正常的HF患者中，右心房起搏使心率增加时，机械性不同步加剧。
