胸腔镜肺静脉隔离对右心室功能的影响：一项初步研究。
Impact of Thoracoscopic Pulmonary Vein Isolation on Right Ventricular Function: A Pilot Study.
机构信息
Department of Cardiothoracic Surgery and Cardiology, University Medical Center Groningen, University of Groningen, P.O. Box 30.001, 9700 RB Groningen, Netherlands.
Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.
出版信息
Biomed Res Int. 2018 Feb 20;2018:7392435. doi: 10.1155/2018/7392435. eCollection 2018.
OBJECTIVE
Thoracoscopic surgical pulmonary vein isolation (sPVI) has been added to the treatment of atrial fibrillation (AF), showing excellent efficacy outcomes. However, data on right ventricular (RV) function following sPVI has never been studied. Our aim was to investigate RV function following sPVI and compare it to patients who underwent endocardial cryoballoon PVI.
METHODS
25 patients underwent sPVI and were pair-matched according to age, sex, and AF type with 21 patients who underwent cryoballoon PVI. RV function was measured using tricuspid annular plane systolic excursion (TAPSE) and RV strain with 2D speckle tracking. Echocardiography was performed at baseline and at median 6-month follow-up.
RESULTS
Age was 54 ± 9 years and 84% were male; AF was paroxysmal in 92%. In the sPVI group, TAPSE was reduced with 31% at follow-up echocardiography ( < 0.001) and RV strain showed a 25% reduction compared to baseline ( = 0.018). In the control group, TAPSE and RV strain did not change significantly (-3% and +13%, = 0.410 and = 0.148). Change in TAPSE and RV strain was significantly different between groups ( ≤ 0.001 and = 0.005).
CONCLUSIONS
This study shows that RV function is significantly decreased following sPVI. This effect was not observed in the cryoballoon PVI control group.
目的
胸腔镜下肺静脉隔离术（sPVI）已被添加到房颤（AF）的治疗中，显示出优异的疗效。然而，sPVI 后右心室（RV）功能的数据从未被研究过。我们的目的是研究 sPVI 后 RV 功能，并将其与接受心内膜冷冻球囊 PVI 的患者进行比较。
方法
25 例患者接受了 sPVI，并根据年龄、性别和 AF 类型与 21 例接受冷冻球囊 PVI 的患者进行配对。使用三尖瓣环平面收缩期位移（TAPSE）和二维斑点追踪技术测量 RV 功能。在基线和中位 6 个月随访时进行超声心动图检查。
结果
年龄为 54 ± 9 岁，84%为男性；AF 为阵发性，占 92%。在 sPVI 组，TAPSE 在随访超声心动图中减少了 31%（ < 0.001），RV 应变与基线相比减少了 25%（ = 0.018）。在对照组中，TAPSE 和 RV 应变无明显变化（-3%和+13%， = 0.410 和 = 0.148）。两组间 TAPSE 和 RV 应变的变化差异显著（ ≤ 0.001 和 = 0.005）。
结论
本研究表明，sPVI 后 RV 功能明显降低。在冷冻球囊 PVI 对照组中未观察到这种效应。
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