Özderya Ahmet, Gülçebi Fatih, Yerlikaya Murat Gökhan, Maz Mehmet Ali, Şahin Sinan, Sayın Muhammet Raşit
Trabzon Kanuni Training and Research Hospital, Department of Cardiology - Trabzon, Turkey.
University of Health Sciences, Trabzon Ahi Evren Thoracic and Cardiovascular Surgery Training and Research Hospital, Department of Cardiology - Trabzon, Turkey.
Rev Assoc Med Bras (1992). 2025 Jun 2;71(4):e20241621. doi: 10.1590/1806-9282.20241621. eCollection 2025.
Cardiac implantable electronic devices are widely used today. Therefore, research is ongoing to provide better device implantation in technical terms. The aim of this study was to investigate the relationship between pre-procedural regional right ventricular strain and post-procedural endocardial R-wave amplitude in patients scheduled to receive an implantable cardiac defibrillator.
A total of 112 patients who underwent single-chamber implantable cardiac defibrillator implantation were included in the study. Right ventricular strain analysis was performed before the procedure, and the following parameters were recorded: four-chamber strain, free wall strain, septal strain, and apical strain. The relationship between R-wave amplitude, calculated after lead implantation in the apical region, and strain parameters was statistically analyzed.
All strain parameters were statistically significantly better in the group with a high R-wave amplitude. Correlation analysis showed that a higher R-wave amplitude was associated with improved right ventricular four-chamber strain (p<0.001, correlation coefficient=0.436), right ventricular free wall strain (p<0.001, correlation coefficient=0.532), right ventricular septal strain (p<0.001, correlation coefficient=0.394), and right ventricular apical strain (p<0.001, correlation coefficient=0.814). In univariable regression analysis, all strain parameters were identified as dependent predictors; however, in multivariable regression analysis, only right ventricular apical strain (p<0.001) was found to be an independent predictor of high R-wave amplitude.
Our study revealed a relationship between the right ventricular apical endocardial R-wave amplitude and all right ventricular strain parameters, especially right ventricular apical strain. We recommend that clinicians perform regional right ventricular strain analysis before implantable cardiac defibrillator implantation in cases where lead positioning is uncertain.
心脏植入式电子设备如今被广泛使用。因此，在技术层面上，为实现更好的设备植入，相关研究正在进行。本研究的目的是调查计划接受植入式心脏除颤器治疗的患者术前局部右心室应变与术后心内膜R波振幅之间的关系。
本研究共纳入112例行单腔植入式心脏除颤器植入术的患者。在手术前进行右心室应变分析，并记录以下参数：四腔应变、游离壁应变、室间隔应变和心尖应变。对心尖区域植入导线后计算得出的R波振幅与应变参数之间的关系进行统计学分析。
R波振幅高的组中，所有应变参数在统计学上均显著更好。相关性分析表明，较高的R波振幅与改善的右心室四腔应变（p<0.001，相关系数=0.436）、右心室游离壁应变（p<0.001，相关系数=0.532）、右心室室间隔应变（p<0.001，相关系数=0.394）和右心室心尖应变（p<0.001，相关系数=0.814）相关。在单变量回归分析中，所有应变参数均被确定为相关预测指标；然而，在多变量回归分析中，仅右心室心尖应变（p<0.001）被发现是高R波振幅的独立预测指标。
我们的研究揭示了右心室心内膜心尖R波振幅与所有右心室应变参数之间的关系，尤其是右心室心尖应变。我们建议，在导线定位不确定的情况下，临床医生在植入式心脏除颤器植入术前进行局部右心室应变分析。
