左海润,徐承义,苏晞

• 1:武汉科技大学附属武汉亚心总医院心内科
• 2:武汉亚洲心脏病医院心内科

摘要(Abstract)：

目的 总结4例植入第五代心肌收缩力调节器（CCM）治疗慢性心力衰竭患者的临床经验。方法 本研究为回顾性研究，连续入选2022年2—5月在武汉亚心总医院接受CCM植入术的患者。收集患者的一般临床基线资料、影像学资料、CCM术中资料、住院期间以及术后1个月的临床随访结果。结果 本研究共纳入4例患者，均为男性，年龄39～72岁。2例患者基础疾病为缺血性心肌病，2例为扩张型心肌病，纽约心脏病协会（NYHA）心功能分级Ⅲ～Ⅳ级。其中3例患者术前基线左心室射血分数（LVEF）为25%～31%,1例患者LVEF<25%;QRS波宽度为108～122 ms。4例患者均接受了3个月以上的优化心力衰竭药物治疗。1例患者在CCM植入术中“一站式”完成植入式心律转复除颤器植入手术。4例患者CCM植入后即刻LVEF均有改善。术后30 d随访时，3例患者LVEF较术前均有显著改善，左心室舒张末期内径（LVEDd）较术前减小，NYHA心功能分级较术前下降一级，1例患者LVEF、LVEDd和NYHA心功能分级均无改善。4例患者术后30 d随访时6min步行试验距离为224～417m，患者自诉活动耐量较术前改善。结论 CCM可改善心力衰竭患者的功能状态、LVEF、运动耐量，是症状性心力衰竭患者的器械治疗方法之一，可在具备相关条件的中心进行。

关键词(KeyWords)： 慢性心力衰竭;心脏再同步化治疗;植入式心律转复除颤器;心脏收缩力调节器

Abstract:

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基金项目(Foundation):

作者(Author): 左海润,徐承义,苏晞

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