升级为左束支起搏后起搏器诱导性心肌病患者的生活质量
The quality of life of patients with pacemaker-induced cardiomyopathy after they upgrade to left bundle branch pacing.
作者信息
Li Huacheng, Wang Long, Peng Xinna, Wu Jiying
机构信息
Department of Cardiovascular Medicine, Qingyang Second People's Hospital Qingyang, Gansu Province, China.
Department of Nursing, Qingyang Second People's Hospital Qingyang, Gansu Province, China.
出版信息
Am J Transl Res. 2021 Apr 15;13(4):3044-3053. eCollection 2021.
OBJECTIVE
To investigate the changes in the cardiac function and quality of life of patients with pacemaker-induced cardiomyopathy (PICM) after they upgrade to left bundle branch pacing (LBBP).
METHODS
Ten patients with PICM who upgraded to LBBP were recruited as the study cohort. The LBBP upgrade operations were all performed by the same cardiac intervention expert. The cardiac function index changes, including the left ventricular end-diastolic diameters, the cardiothoracic ratios, the left ventricular ejection fractions, the N-terminal brain natriuretic peptide levels, the 6 min walking test distances, and the quality of life changes, including the SF-36 scores, the European Five-Dimensional Health Scale (EQ-5D-3L) scores, and the Minnesota Heart failure Quality of Life Scale (MLHFQ) scores before and after the LBBP operations were analyzed. The incidences of adverse events during the postoperative follow-up were analyzed.
RESULTS
The ten patients were successfully upgraded to LBBP. Compared with before the operation, the left ventricular end-diastolic diameter levels and the cardiothoracic ratios decreased significantly, but the left ventricular ejection fractions and the 6 min walking test distances increased (P<0.05 or P<0.01). The SF-36 and EQ-5D-3L scores increased gradually, but the MLHFQ scores decreased gradually before the operations and at one month and 12 months after the operations. The physical functioning (PF), role-physical (RP), general health (GH), vitality (VT), and the social role (SR) scores of the SF-36 scale, the TTO index and the visual analog scale (VAS) of the EQ-5D-3L scale scores, and the MLHFQ scores at 12 months after the operations were significantly different from the scores before the operations (all P<0.05). In terms of safety, there were no adverse events such as pacemaker electrode dislocation or interventricular septal perforation during the postoperative follow-up.
CONCLUSION
Upgrading to LBBP can effectively improve cardiac function and the quality of life in patients with PICM, and the operation is safe.
目的
探讨起搏器介导的心肌病（PICM）患者升级为左束支起搏（LBBP）后心脏功能及生活质量的变化。
方法
选取10例升级为LBBP的PICM患者作为研究队列。所有LBBP升级手术均由同一位心脏介入专家进行。分析LBBP手术前后心脏功能指标变化，包括左心室舒张末期内径、心胸比率、左心室射血分数、N末端脑钠肽水平、6分钟步行试验距离，以及生活质量变化，包括SF-36评分、欧洲五维健康量表（EQ-5D-3L）评分和明尼苏达心力衰竭生活质量量表（MLHFQ）评分。分析术后随访期间不良事件的发生率。
结果
10例患者成功升级为LBBP。与手术前相比，左心室舒张末期内径水平和心胸比率显著降低，但左心室射血分数和6分钟步行试验距离增加（P<0.05或P<0.01）。SF-36和EQ-5D-3L评分逐渐升高，但MLHFQ评分在手术前、术后1个月和12个月逐渐降低。术后12个月时，SF-36量表的身体功能（PF）、角色-身体（RP）、总体健康（GH）、活力（VT）和社会角色（SR）评分、EQ-5D-3L量表评分的TTO指数和视觉模拟量表（VAS）以及MLHFQ评分与手术前评分相比有显著差异（均P<0.05）。在安全性方面，术后随访期间未发生起搏器电极脱位或室间隔穿孔等不良事件。
结论
升级为LBBP可有效改善PICM患者的心脏功能和生活质量，且手术安全。
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