植入可能な心臓変容器除細動器および心臓再同期療法
Johannes Holzmeister1, Christophe Leclercq
1Department of Cardiology and Cardiac Surgery, University Hospital Zurich, Zurich, Switzerland. johannes.holzmeister@usz.ch
Lancet (London, England)
|August 23, 2011
まとめ
心臓再同期療法 (CRT) は,心不全患者のアウトカムを改善します. 現在のガイドラインでは,症状のある患者と軽度の症状のある患者の両方に対してCRTを推奨しており,拡大された徴候と最適化戦略に関する研究が進行中です.
科学分野:
- 心臓病学 心臓病学
- 医療機器 医療機器について
- 心不全管理について
背景:
- 植入可能な心臓変容器除細動器と心臓再同期療法 (CRT) は,心不全の標準的な治療法である.
- 症状のある (NYHAクラスIII) と軽度の症状のある (NYHAクラスII) 心不全の患者でCRTの効果を裏付ける証拠があります.
研究 の 目的:
- CRTに関する画期的なランダム化臨床試験 (REVERSE,MADIT-CRT,RAFT) を批判的に評価する.
- 特定の患者サブグループと最適化を含むCRTの新興 indikaを議論する.
主な方法:
- 画期的なランダム化臨床試験のレビューと批判的評価.
- 拡張されたCRTの徴候と患者の応答に関する証拠の議論.
主要な成果:
- CRTは,NYHAクラスIIおよびIIIの心不全患者の両方に推奨されます.
- 証拠は,軽く減少したLVEFと狭いQRSを有する患者のCRTを探求することを支持しています.
結論:
- CRTは,より広範な患者集団のための心不全管理の礎石です.
- 非応答者およびCRTの有効性を改善するために,さらなる研究と最適化が不可欠です.
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