经静脉起搏器和植入式心脏复律除颤器导线置入对三尖瓣功能的影响：一项观察性研究。
The effect of transvenous pacemaker and implantable cardioverter defibrillator lead placement on tricuspid valve function: an observational study.
作者信息
Kim Juyong B, Spevack Daniel M, Tunick Paul A, Bullinga John R, Kronzon Itzhak, Chinitz Larry A, Reynolds Harmony R
机构信息
Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, New York, USA.
出版信息
J Am Soc Echocardiogr. 2008 Mar;21(3):284-7. doi: 10.1016/j.echo.2007.05.022. Epub 2007 Jul 2.
This study assessed the effect of transtricuspid placement of permanent pacemaker (PPM) and implantable cardioverter defibrillator (ICD) leads on tricuspid regurgitation (TR) in 248 patients with echocardiograms before and after placement. Some 21.2% of patients with baseline mild TR or less developed abnormal TR (3.4% mild-moderate, 12.8% moderate, 1.1% moderate-severe, 3.9% severe) after implant. TR worsened by 1 grade or more after implant in 24.2% (20.7% of PPMs vs. 32.4% of ICDs; P < .05). TR worsening was more common with ICDs than PPMs in patients with baseline mild TR or less. After lead implantation, abnormal TR developed in 21.2% and severe TR developed in 3.9% of patients with initially normal TR. TR worsened by at least 1 grade in 24.2%. Patients with ICDs had a higher rate of TR worsening compared with patients with PPMs (32.4% vs. 20.1%; P < .05).
本研究评估了248例患者在植入永久性起搏器（PPM）和植入式心脏复律除颤器（ICD）导线经三尖瓣放置前后，对三尖瓣反流（TR）的影响。植入后，约21.2%基线为轻度TR或更轻的患者出现异常TR（3.4%为轻度至中度，12.8%为中度，1.1%为中度至重度，3.9%为重度）。植入后TR恶化1级或以上的患者占24.2%（PPM为20.7%，ICD为32.4%；P<0.05）。在基线为轻度TR或更轻的患者中，ICD导致TR恶化比PPM更常见。导线植入后，最初TR正常的患者中有21.2%出现异常TR，3.9%出现重度TR。TR至少恶化1级的患者占24.2%。与PPM患者相比，ICD患者TR恶化的发生率更高（32.4%对20.1%；P<0.05）。
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