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运动诱发左束支传导阻滞导致严重二尖瓣反流。

Exercise-Induced Left Bundle Branch Block Resulting in Severe Mitral Regurgitation.

作者信息

Ingraham Brenden S, Chareonthaitawee Panithaya, Reddy Yogesh N V

机构信息

Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.

出版信息

JACC Case Rep. 2021 Aug 19;3(10):1287-1290. doi: 10.1016/j.jaccas.2021.06.029. eCollection 2021 Aug 18.

DOI:10.1016/j.jaccas.2021.06.029
PMID:34471879
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8387835/
Abstract

Exercise hemodynamic catheterization is helpful to evaluate exertional symptoms when noninvasive investigations fail to provide an explanation in non-ischemic cardiomyopathy. In this case, a rate-related left bundle branch block resulted in severe dynamic mitral regurgitation and acute increase in pulmonary capillary wedge pressure. Cardiac resynchronization therapy resolved her symptoms. ().

摘要

当无创检查无法对非缺血性心肌病的劳力性症状作出解释时，运动血流动力学导管检查有助于评估此类症状。在该病例中，心率相关的左束支传导阻滞导致严重的动态二尖瓣反流及肺毛细血管楔压急性升高。心脏再同步治疗缓解了她的症状。（）

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9382/8387835/5b1a31daf5eb/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9382/8387835/8de4d95124b7/fx1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9382/8387835/5795080a7429/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9382/8387835/10bf849af705/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9382/8387835/5b1a31daf5eb/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9382/8387835/8de4d95124b7/fx1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9382/8387835/5795080a7429/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9382/8387835/10bf849af705/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9382/8387835/5b1a31daf5eb/gr3.jpg

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本文引用的文献

1
Coexistence of dynamic mitral regurgitation and dynamic left ventricular dyssynchrony in a patient with repeated episodes of acute pulmonary edema: improvement with cardiac resynchronization therapy.一名反复发生急性肺水肿的患者同时存在动态二尖瓣反流和动态左心室不同步：心脏再同步治疗后病情改善
Rev Port Cardiol. 2013 Dec;32(12):1031-5. doi: 10.1016/j.repc.2013.06.013. Epub 2013 Nov 25.
2
Mechanism of improvement in mitral regurgitation after cardiac resynchronization therapy.心脏再同步治疗后二尖瓣反流改善的机制
Eur Heart J. 2008 Mar;29(6):757-65. doi: 10.1093/eurheartj/ehn063. Epub 2008 Feb 27.
3
Early and late effects of cardiac resynchronization therapy on exercise-induced mitral regurgitation: relationship with left ventricular dyssynchrony, remodelling and cardiopulmonary performance.
心脏再同步治疗对运动诱发二尖瓣反流的早期和晚期影响：与左心室不同步、重构及心肺功能的关系
Eur Heart J. 2007 Sep;28(17):2134-41. doi: 10.1093/eurheartj/ehm126. Epub 2007 May 15.
4
Dynamic ventricular dyssynchrony: an exercise-echocardiography study.动态心室不同步：一项运动超声心动图研究。
J Am Coll Cardiol. 2006 Jun 6;47(11):2253-9. doi: 10.1016/j.jacc.2005.11.087.
5
Acute effects of cardiac resynchronization therapy on functional mitral regurgitation in advanced systolic heart failure.心脏再同步治疗对晚期收缩性心力衰竭患者功能性二尖瓣反流的急性影响。
J Am Coll Cardiol. 2003 Mar 5;41(5):765-70. doi: 10.1016/s0735-1097(02)02937-6.