评估心脏再同步治疗急性反应的脑卒中工作量或收缩期 dp/dtmax：它们可以互换吗？

Stroke work or systolic dP/dtmax to evaluate acute response to cardiac resynchronization therapy: are they interchangeable?

机构信息

Department of Cardiology, VU University Medical Center, 1081 HV Amsterdam, The Netherlands.

出版信息

Eur J Heart Fail. 2009 Jul;11(7):706-8. doi: 10.1093/eurjhf/hfp069.

DOI:10.1093/eurjhf/hfp069

PMID:19553399

Abstract

BACKGROUND

Cardiac resynchronization therapy (CRT) is characterized by a approximately 30% non-response. Invasive haemodynamic measurements are a traditional method to evaluate response to CRT. This study evaluates the correlation between acute changes in dP/dt(max) and Stroke Work (SW) during CRT.

METHODS

Thirty-four CRT candidates were haemodynamically evaluated by pressure-volume loop analysis during biventricular pacing.

RESULTS

Mean dP/dt(max) and SW at baseline were 854 +/- 198 and 5186 +/- 2349, and displayed an increase during pacing of 106 +/- 117 mmHg/s (13% +/- 14%) and 1303 +/- 3039 mL/mmHg (30% +/- 52%), respectively. No correlation was found between the percentage change in dP/dt(max) and SW (R = 0.06, P = ns). When defining response an augmentation of 10% relative to baseline for both parameters, 16 patients demonstrated an ambiguous response.

CONCLUSION

Although both parameters display an average increase during pacing, the change relative to baseline values of SW and dP/dt(max) is not related.

摘要

背景

心脏再同步治疗（CRT）的特征为约 30%的无应答。有创血流动力学测量是评估 CRT 应答的传统方法。本研究评估 CRT 期间 dP/dt(max)和Stroke Work（SW）的急性变化之间的相关性。

方法

34 名 CRT 候选者通过双心室起搏期间的压力-容积环分析进行血流动力学评估。

结果

平均基线 dP/dt(max)和 SW 分别为 854 ± 198 和 5186 ± 2349，起搏期间分别增加 106 ± 117 mmHg/s（13% ± 14%）和 1303 ± 3039 mL/mmHg（30% ± 52%）。dP/dt(max)和 SW 的变化百分比之间没有相关性（R = 0.06，P = ns）。当定义应答时，两个参数相对于基线的增加幅度均为 10%，16 名患者的应答不明确。