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|本期目录/Table of Contents|

心脏再同步化治疗晚期扩张型心肌病13例的效果

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2010年第2期
页码:
246-248
栏目:
临床研究
出版日期:
2010-03-04

文章信息/Info

Title:
Effect of cardiac resynchronization therapy on 13 patients with dilated cardiomyopathy
作者:
蔡彬妮; 黄卫斌; 王挹青; 陈超; 万发珢; 王炎
厦门大学附属中山医院 厦门心脏中心，福建 厦门 361004
Author(s):
CAI Bin-ni;  HUANG Wei-bin;  WANG Yi-qing;  CHEN Chao;  WAN Fa-yin;  WANG Yan
Department of Cardiology, Xiamen Heart Center, Zhongshan Hospital of Xiamen University, Xiamen 361004, Fujian, China
关键词:
心脏再同步化治疗; 充血性心力衰竭; 扩张型心肌病
Keywords:
cardiac resynchronization therapy;  congestive heart failure;  dilated cardiomyopathy
分类号:
R541.61
DOI:
-
文献标识码:
A
摘要:
目的: 观察心脏再同步化治疗（CRT）晚期充血性心力衰竭的临床疗效。方法: 晚期扩张型心肌病患者13例接受CRT，NYHA心功能分级为Ⅲ～Ⅳ级，左室射血分数（LVEF）为（27.4±9.7）%，左室舒张末期内径（LVEDD）为(72.8±9.6)mm，QRS时限为( 137.8＋30.4)ms。术后观察QRS时限的变化，随访左室电极起博阈值、心功能分级、LVEF及LVEDD。结果: 术后QRS时限减少为（123.8±17.1）ms。所有患者随访3～38月，左室电极慢性阈值为（1.1±0.6）V/0.4 ms。与术前相比，NYHA心功能分级从(3.4±0.5)降低为(1.5±0.9)； LVEF从(27.4±9.7)%上升至(43.5±18.5)%(P<0.05)；LVEDD从(72.8±9.6)mm缩小为(65.5±11.6)mm（P<0.05）。结论: CRT可改善心功能，提高LVEF，并可逆转左心室重构。
Abstract:
AIM: To investigate the effect of cardiac resynchronization therapy (CRT) on dilated cardiomyopathy (DCM). METHODS: Thirteen patients with DCM were implanted with synchronous biventricular pacemakers. All patients had NYHA class III to IV heart failure with ejection fraction (EF) (27.4±9.7)%, left ventricular end-diastolic diameter (LVEDD) (72.8±9.6) mm and QRS duration of (137.8±30.4) msec. Serial assessment was performed before and after pacing. RESULTS: After a follow-up period of 3-38 months, there were significant improvements of NYHA class of heart function from (3.4±0.5) to (1.5±0.9). EF increased from (27.4±9.7)% to (43.5±18.5)% (P<0.05) and the LVEDD decreased from (72.8±9.6) mm to (65.5±11.6) mm (P<0.05). CONCLUSION: For patients with NYHA class III to IV heart failure and ventricular conduction delay, cardiac resynchronization therapy can reverse left ventricular remodeling and improve heart function.

参考文献/References

［1］ Abraham WT, Fisher WG, Smith AL, et al. Cardiac resynchronization in chronic heart failure (MIRACLE)［J］. N Engl J Med, 2002, 346(24):1845-1853.

［2］ Leclercq C, Kass DA. Retiming the failing heart: principles and current clinical status of cardiac resynchronization［J］. J Am Coll Cardiol, 2002, 39(2):194-201.

［3］ Birnie DH, Tang AS. The problem of non-response to cardiac resynchronization therapy［J］. Curr Opin Cardiol, 2006, 21(1):20-26.

［4］ Yu CM, Fung WH, Zhang Q, et al. Understanding nonresponders of cardiac resynchronization therapy-current and future perspectives［J］. J Cardiovasc Electrophysiol, 2005, 16(10):1117-1124.

［5］ Bleeker GB, Schalij MJ, Molhoek SG, et al. Relationship between QRS duration and left ventricular dyssynchrony in patients with end-stage heart failure［J］. J Cardiovasc Electrophysiol, 2004, 15(5):544-549.

［6］ Achilli A, Sassara M, Ficili S, et al. Long-term effectiveness of cardiac resynchronization therapy in patients with refractory heart failure and “narrow” QRS［J］. J Am Coll Cardiol, 2003, 42(12):2117-2124.

备注/Memo

备注/Memo:
收稿日期：2008-7-16.通讯作者：黄卫斌，副主任医师，主要从事起搏与心电生理的研究Email:xmhuangbo@163.com 作者简介：蔡彬妮，主治医师，硕士Email:xmzscbn@sina.com
更新日期/Last Update: 2010-03-05