■呼吸运动管理策略用于最大程度地减少呼吸对室性心动过速的立体定向消融放射治疗精度的影响,但是人类心脏收缩运动的程度尚未得到系统的探索。
■我们旨在评估心脏中不同方向和位置之间的心脏收缩运动幅度。
■回顾性研究了在2个医疗中心接受房性或室性心律失常导管消融术前接受4维心脏计算机断层扫描(CT)检查的心内导线或瓣膜患者。经静脉右心耳移位,右心室(RV)可植入心脏复律除颤器,冠状窦导线尖端,在最大强度投影CT重建上以正交3维视图测量整个心动周期的人工心脏设备。
■共分析了31次消融前心脏4维心脏CT扫描。与RV导线相比,LV导线尖端在前后方向(6.0±2.2mmvs3.8±1.7mm;P=0.01)和上下方向(4.4±2.9mmvs3.5±2.0mm;P=0.049)上的运动明显更大。人工主动脉瓣在所有基准点中运动最少,特别是与右心室导线尖端在左右方向(3.2±1.2mmvs6.1±3.8mm,P=.04)和前后方向的LV导线尖端(3.8±1.7mmvs6.0±2.2mm,P=.03)。
■心脏收缩运动的程度在心脏的不同位置之间显着变化(1毫米至15.2毫米)。应根据患者的具体情况评估收缩运动对放射治疗精度的影响。
UNASSIGNED: Respiratory motion management strategies are used to minimize the effects of breathing on the precision of stereotactic ablative radiotherapy for ventricular tachycardia, but the extent of cardiac contractile motion of the human heart has not been systematically explored.
UNASSIGNED: We aim to assess the magnitude of cardiac contractile motion between different directions and locations in the heart.
UNASSIGNED: Patients with intracardiac leads or valves who underwent 4-dimensional cardiac computed tomography (CT) prior to a catheter ablation procedure for atrial or ventricular arrhythmias at 2 medical centers were studied retrospectively. The displacement of transvenous right atrial appendage, right ventricular (RV) implantable cardioverter-defibrillator, coronary sinus lead tips, and prosthetic cardiac devices across the cardiac cycle were measured in orthogonal 3-dimensional views on a maximal-intensity projection CT reconstruction.
UNASSIGNED: A total of 31 preablation cardiac 4-dimensional cardiac CT scans were analyzed. The LV lead tip had significantly greater motion compared with the RV lead in the anterior-posterior direction (6.0 ± 2.2 mm vs 3.8 ± 1.7 mm; P = .01) and superior-inferior direction (4.4 ± 2.9 mm vs 3.5 ± 2.0 mm; P = .049). The prosthetic aortic valves had the least movement of all fiducials, specifically compared with the RV lead tip in the left-right direction (3.2 ± 1.2 mm vs 6.1 ± 3.8 mm, P = .04) and the LV lead tip in the anterior-posterior direction (3.8 ± 1.7 mm vs 6.0 ± 2.2 mm, P = .03).
UNASSIGNED: The degree of cardiac contractile motion varies significantly (1 mm to 15.2 mm) across different locations in the heart. The effect of contractile motion on the precision of radiotherapy should be assessed on a patient-specific basis.