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CARTOSound引导下射频消融治疗肥厚型梗阻性心肌病患者的临床效果
Clinical efficacy of CARTOSound-guided radiofrequency ablation for hypertrophic obstructive cardiomyopathy
- 第三军医大学学报 2021年43卷第8期 页码：736-740
- 作者机构：
400038 重庆，陆军军医大学(第三军医大学)第一附属医院心血管内科
- 作者简介：
[舒茂琴，E-mail: shumaoqinswh@sina.com SHU Maoqin, E-mail: shumaoqinswh@sina.com
- 基金信息：第三军医大学第一附属医院院管课题(SWH2016JSTSYB-4)
DOI：10.16016/j.1000-5404.202009168
中图分类号： R445.1;R540.46;R542.2收稿：2020-09-20，
修回：2020-12-09，
纸质出版：2021-04-30
- 稿件说明：
移动端阅览
蒋周芩, 舒茂琴, 柴虹, 等. CARTOSound引导下射频消融治疗肥厚型梗阻性心肌病患者的临床效果[J]. 第三军医大学学报, 2021,43(8):736-740.
Zhouqin JIANG, Maoqin SHU, Hong CHAI, et al. Clinical efficacy of CARTOSound-guided radiofrequency ablation for hypertrophic obstructive cardiomyopathy[J]. Journal of Third Military Medical University, 2021, 43(8): 736-740.
蒋周芩, 舒茂琴, 柴虹, 等. CARTOSound引导下射频消融治疗肥厚型梗阻性心肌病患者的临床效果[J]. 第三军医大学学报, 2021,43(8):736-740. DOI： 10.16016/j.1000-5404.202009168.
Zhouqin JIANG, Maoqin SHU, Hong CHAI, et al. Clinical efficacy of CARTOSound-guided radiofrequency ablation for hypertrophic obstructive cardiomyopathy[J]. Journal of Third Military Medical University, 2021, 43(8): 736-740. DOI： 10.16016/j.1000-5404.202009168.
摘要
目的
2
探讨CARTOSound引导下射频消融对肥厚型梗阻性心肌病患者的临床疗效。
方法
2
连续入选2019年6-12月在本院心血管内科就诊的经超声心动图证实存在收缩期二尖瓣前叶前向运动(systolic anterior motion
SAM)现象的肥厚型梗阻性心肌病患者，就其临床特征、消融策略及消融效果进行回顾性分析。根据消融效果不同分为反应组和非反应组，分析影响消融效果的因素。
结果
2
共入选1
1例，其中男性3例，女性8例，年龄44~77(58.36±10.82)岁，病史6个月至2年，患者经消融后腔内即刻静息跨左心室流出道压力阶差(20.00±31.12 mmHg
vs
57.09±33.44 mmHg，
P
=0.01)及早搏刺激后跨左心室流出道压力阶差(24.09±19.34 mmHg
vs
139.60±44.52 mmHg，
P
<
0.01)均明显下降，随访3个月后心脏超声提示室间隔厚度(18.15±92.84 mm)较术前无明显差异(19.50±2.67 mm，
P
=0.35)，跨左心室流出道压力阶差较术前有所下降，但无统计学差异(71.09±31.40 mmHg
vs
52.38±35.76 mmHg，
P
=0.28)，术后6个月随访结果相似，但患者NYHA明显改善(1.64±0.15
vs
2.36±0.20，
P
<
0.01)。与非反应组(5例)比较，反应组(6例)患者有室间隔厚度更薄、左心室直径更小、BNP更低的趋势。
结论
2
CARTOsound引导下射频消融治疗肥厚型梗阻性心肌病患者可改善心功能，短期内可缓解左心室流出道梗阻。
Abstract
Objective
2
To investigate the clinical efficacy of CARTOSound-guided radiofrequency ablation on hypertrophic obstructive cardiomyopathy.
Methods
2
The consecutive patients with hypertrophic obstructive cardiomyopathy accompanied with systolic anterior mitral valve movement (SAM) confirmed by echocardiography in our hospital from June to December 2019 were enrolled in this study. A retrospective study was carried out on the clinical features
ablative strategies and ablative effects. According to the ablation effects
the patients were divided into response group and non-response group
and the factors affecting the ablation effect were analyzed.
Results
2
There were 11 enrolled patients (3 males and 8 females
aged 58.36±10.82 years
ranging from 44 to 77 years) with a history of hypertrophic obstructive cardiomyopathy for 6 months to 2 years. The left ventricular outflow tract gradient (LVOTG) at rest (20.00±31.12
vs
57.09±33.44 mmHg
P
=0.01) and at ventricular premature beat stimulation (24.09±19.34
vs
139.60±44.52 mmHg
P
<
0.01) were significantly decreased immediately in the patients after ablation. After 3 month
s follow-up
echocardiography showed no significant difference in ventricular septal thickness compared with that before ablation (18.15±92.84
vs
19.50±2.67 mm
P
=0.35)
and the LVOGT was decreased slightly and had no statistical difference (71.09±31.40
vs
52.38±35.76 mmHg
P
=0.28). Similiar results were seen after 6 months follow-up
but the NYHA grade was significantly improved (1.64±0.15
vs
2.36±0.20
P
<
0.01). The ventricular septal thickness was thinner
the left ventricular diameter was smaller
and B-type natriuretic peptide (BNP) level was lower in the response group (
n
=6) than those in the non-response group (
n
=5).
Conclusion
2
CARTOsound-guided radiofrequency ablation can improve cardiac function and alleviate short-term left ventricular outflow tract obstruction in the patients with hypertrophic obstructive cardiomyopathy.
关键词
Keywords
references
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