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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