Alizadehasl Azin, Akbarzadeh Mohammad Ali, Sadeghpour Anita, Haghjoo Majid, Ghadrdoost Behshid, Zeighami Mahbubeh, Talab Arezoo Haghighat
Rajaie Cardiovascular Medical and Research Center, Valiasr Street, Tehran, Iran.
Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Indian Heart J. 2018 Dec;70 Suppl 3(Suppl 3):S60-S63. doi: 10.1016/j.ihj.2018.05.009. Epub 2018 May 24.
According to American Heart Association guidelines, QRS duration and morphology are used to select patients for cardiac resynchronization therapy (CRT). But still there are some patients who are not responding to this device. We investigated whether the Cardiogoniometry (CGM) as a three-dimensional vectorcardiogram method can improve patient selection.
Echocardiography and CGM were performed for 25 consecutive patients with Left bundle branch morphology who were candidate for CRT implantation and were in sinus rhythm. Patients re-evaluated by echocardiography after 6 months post CRT implantation.
The mean age of the patients was 63 ± 13 years and 17 (68%) were males. The mean LVEF was 19.4 ± 7.4% and 24.2 ± 11.5% before and after CRT implantation respectively. Median of the duration of the R loop before the R maximum demonstrated a negative correlation with the increase in LVEF, (r = -0.36, P = 0.07) and mean of maximal spatial velocity of the T-loop for all measured showed a positive correlation (r = 0.39, p = 0.04). Other parameters didn't show any significant differences.
Three-dimensional vectorcardiogram parameters can be helpful to predict the CRT response. Shorter duration of the R loop before the maximum R and smaller R loop area are predictors for responder patients.
根据美国心脏协会指南，QRS波时限和形态用于选择心脏再同步治疗（CRT）的患者。但仍有一些患者对该设备无反应。我们研究了作为三维向量心电图方法的心脏角度测量法（CGM）是否能改善患者的选择。
对25例连续的左束支形态、符合CRT植入标准且为窦性心律的患者进行超声心动图和CGM检查。CRT植入后6个月通过超声心动图对患者进行重新评估。
患者的平均年龄为63±13岁，17例（68%）为男性。CRT植入前后的平均左心室射血分数（LVEF）分别为19.4±7.4%和24.2±11.5%。R波最大值之前R环持续时间的中位数与LVEF的增加呈负相关（r = -0.36，P = 0.07），所有测量的T环最大空间速度平均值呈正相关（r = 0.39，p = 0.04）。其他参数未显示任何显著差异。
三维向量心电图参数有助于预测CRT反应。R波最大值之前R环持续时间较短和R环面积较小是反应良好患者的预测指标。
