【摘要】 目的：观察右心室起搏对肥厚型梗阻性心肌病（ＨＣＭ）患者的远期临床、血液动力学及形态学变化，以确定右心室起搏对其治疗效果及预后影响。 方法：对３０例ＨＣＭ患者采用有创血液动力学监测及多普勒超声心动图方法观察右心室起搏前及５年后患者的血液动力学及形态变化。 结果：右心室起搏５年后临床症状、心功能、血液动力学及超声心动日均显著改变，尤其二尖瓣收缩期前向运动（ＳＡＭ）、左心室流出道宽度、左心室流出道压力阶差（ＬＶＯＴＧ）、左心室舒张末期压、心排血量及心脏指数改善更为显著（Ｐ＜０．００１），肥厚的心室间隔显著变薄（Ｐ＜０．０５）。 结论：右心室起搏能显著地改善患者的临床症状，心功能及血液动力学，其远期疗效显著，并发现能逆转肥厚的心室间隔及左心室游离壁，改善左心室流出道梗阻。因此为ＨＣＭ的起搏治疗提供了客观依据、对药物治疗无效或疗效不满意的患者，起搏治疗可能成为较理想的治疗措施。更多还原

【Abstract】 Objective: To analyze the long-term effectiveness of hypertrophic cardiomyopathy(HCM) patients treated with right ventricular pacing. Methods:Thirty patients with HCM treated with right ventricular pacing for 5 years were included in this study. Hemodynamic changes were observed by invasive before right ventricular pacing and 5-years later. Results: The clinical symptoms, heart function and hemodynamic parameters were significantly improved (p< 0.001). Conclusion:Good long-term effect could be obtained in patients with HCM treated by right ventracular pacing. It could improve the hemodynamic defects caused by hypertrophic ventrcular septum,RV pacing would be probaly an ideal alternative treatment for patients with HCM whose symptoms were not relieved with drugs.更多还原