心脏再同步化治疗慢性心力衰竭的临床疗效Clinical study of the effect of cardiac resynchronization therapy in patients of chronic heart failure
苏晞,李振,韩宏伟
摘要(Abstract):
目的观察心脏再同步化治疗对慢性心力衰竭患者改善心功能和逆转左心室重构的作用。方法11例慢性心力衰竭患者接受心脏再同步化治疗,心功能NYHA分级Ⅲ~Ⅳ级,左室射血分数≤35%,伴QRS波时限≥130ms。随访1~36个月,观察和分析术前、术后相关参数的基准水平及参数基准水平的变量。结果心脏再同步化治疗后1~36个月,左心室射血分数、左心室短轴缩短率增加,左心室舒张末内径、二尖瓣返流、QRS波时限减少,NYHA分级提高到Ⅰ~Ⅱ级,6min步行距离明显增加。结论对于心功能NYHA分级Ⅲ级或Ⅳ级伴有室内传导阻滞的心力衰竭患者,心脏再同步化治疗能逆转左心室重构,改善心功能。
关键词(KeyWords): 心脏再同步化治疗;心力衰竭,充血性;慢性病
基金项目(Foundation):
作者(Author): 苏晞,李振,韩宏伟
参考文献(References):
- 1AbrahamWT,FisherWG,SmithAL,etal.Cardiacresynchronization inchronicheartfailure.NEnglJMed,2002,346:19021905.
- 2CazeauS,LeelercqC,LavergneT,etal.Effectsofmultisite biventricularpacinginpatientswithheartfailureandintraventricular conductiondelay.NEnglJMed,2001,344:873880.
- 3AuricchioA,StellbrinkC,SackS,etal.Long termclinicaleffectof hemodynamicallyoptimizedcardiacresynchronizationtherapyinpatients withheartfailureandventricularconductiondelay.JAmCollCardiol,2002,39:20262033.
- 4BristowMR,FeldmanAM,SaxonLA,etal.Cardiac resynchronization therapywithorwithoutanimplantabledefibrillatorinadvancedchronic heartfailure.NEnglJMed,2004,350:21402150.
- 5AuricchioA,StellbrinkC,SackS,etal.ThePacingTherapiesfor CongestiveHeartFailure(PATH CHF)study:rationale,design,and endpointsofaprospectiverandomizedmulticenterstudy.AmJCardiol,1999,83:130D135D.
- 6CazeauS,LeclercqC,LavergneT,etal.Effectsofmultisite biventricularpacinginpatientswithheartfailureandintraventricular conductiondelay(MUSTIC).NEnglJMed,2001,344:873880.
- 7AbrahamWT,FisherWG,SmithAL,etal.Cardiacresynchronization inchronicheartfailure(MIRACLE).NEnglJMed,2002,346:18451853.
- 8YuCM,LinH,ZhangQ,etal.Highprevalenceofleftventricular systolicanddiastolicasync hronyinpatientswithcongestiveheart failureandnormalQRSduration.Heart,2003,89:5460.
- 9Garrigue,ReuterS,LabequeJN,etal.Usefulnessofbiventricular pacinginpatientswithcongestiveheartfailureandrightbundlebranch block.AmJCardiol,2001,88:14361441.
- 10PierreB,StephaneL.Echoardiographicparametersofventricular dyssynchronyvalidationinpatientswithheartfailureusingsequential biventricularpacing.JACC,2004,11:21572165.