Raichlen J S, Links J M, Reid P R
Am J Cardiol. 1985 Jan 1;55(1):84-8. doi: 10.1016/0002-9149(85)90304-2.
Some patients with ventricular tachycardia (VT) remain virtually asymptomatic, whereas others have syncope despite similar VT rates. The role of ventricular activation site on left ventricular (LV) function was examined in 10 patients undergoing electrophysiologic evaluation for recurrent ventricular arrhythmias. Radionuclide ventriculograms were acquired to calculate LV volumes and aortic or LV pressure was measured during right atrial and right ventricular (RV) pacing. RV apical pacing resulted in end-diastolic volumes similar to those achieved with right atrial pacing (171 +/- 27 vs 175 +/- 19 ml), whereas RV outflow tract pacing showed a trend toward lower volumes (168 +/- 32 vs 177 +/- 33 ml). Comparison between RV apical and RV outflow tract pacing showed that apical activation resulted in higher end-diastolic volumes (216 +/- 26 vs 194 +/- 22 ml, p = 0.020), end-systolic volumes (175 +/- 25 vs 158 +/- 20 ml, p = 0.041), stroke volumes (42 +/- 4 vs 36 +/- 6 ml, p = 0.046), peak rates of LV ejection (309 +/- 57 vs 245 +/- 40 ml/s, p = 0.034) and peak rates normalized for differences in end-diastolic volume (1.5 +/- 0.3 vs 1.3 +/- 0.3; p = 0.047) without a significant increase in peak pressures (131 +/- 12 vs 127 +/- 14 mm Hg, p greater than 0.30) or ejection fractions (24 +/- 5 vs 22 +/- 4%, p = 0.187). These changes were accompanied by an increase in LV/RV stroke count ratios during RV apical vs RV outflow tract pacing (1.6 +/- 0.2 vs 1.2 +/- 0.2, p = 0.030), suggesting the development of mitral regurgitation.(ABSTRACT TRUNCATED AT 250 WORDS)
一些室性心动过速（VT）患者几乎没有症状，而另一些患者尽管室速频率相似却会出现晕厥。在10例因复发性室性心律失常接受电生理评估的患者中，研究了心室激动部位对左心室（LV）功能的作用。采集放射性核素心室造影以计算左心室容积，并在右心房和右心室（RV）起搏期间测量主动脉或左心室压力。右心室心尖部起搏导致舒张末期容积与右心房起搏时相似（171±27 vs 175±19 ml），而右心室流出道起搏显示容积有降低趋势（168±32 vs 177±33 ml）。右心室心尖部起搏与右心室流出道起搏的比较显示，心尖部激动导致更高的舒张末期容积（216±26 vs 194±22 ml，p = 0.020）、收缩末期容积（175±25 vs 158±20 ml，p = 0.041）、每搏量（42±4 vs 36±6 ml，p = 0.046）、左心室射血峰值速率（309±57 vs 245±40 ml/s，p = 0.034）以及针对舒张末期容积差异进行标准化后的峰值速率（1.5±0.3 vs 1.3±0.3；p = 0.047），而峰值压力（131±12 vs 127±14 mmHg，p＞0.30）或射血分数（24±5 vs 22±4%，p = 0.187）无显著增加。这些变化伴随着右心室心尖部起搏与右心室流出道起搏期间左心室/右心室每搏量计数比值增加（1.6±0.2 vs 1.2±0.2，p = 0.030），提示二尖瓣反流的发生。（摘要截断于250字）
