通过心脏再同步治疗减少了心室体积和改善了缩功能:一项随机试验比较了同时双心室节奏,顺序双心室节奏和左心室节奏
Rajni K Rao1, Uday N Kumar, Jill Schafer
1University of California, San Francisco, Department of Medicine, Division of Cardiology, 505 Parnassus Ave, San Francisco, CA 94143-0214, USA.
Circulation
|April 11, 2007
概括
与心力衰竭患者的LV节奏相比,同时进行的双心室 (BiV) 节奏显示出左心室 (LV) 大小的更大改善的趋势. 同时BiV和顺序BiV节奏之间观察到的差异很小.
科学领域:
- 心脏病学 心脏病学
- 医疗器械 医疗器械
- 心脏衰竭管理的管理
背景情况:
- 心脏再同步治疗 (CRT) 对于晚期静心性心力衰竭至关重要.
- 最佳的CRT节奏模式 (同时双心室,顺序双心室或左心室) 仍然不确定.
- DECREASE-HF试验是这些CRT模式的第一个随机比较.
研究的目的:
- 为了比较心力衰竭患者同时双心室 (BiV),顺序BiV和左心室 (LV) 节奏的有效性.
- 评估不同CRT节奏模式对左心室尺寸和功能的影响.
主要方法:
- 在DECREASE-HF试验中,306名患有晚期心力衰竭的患者随机接受了同时BiV,顺序BiV或LV节奏.
- 心声学评估了基线,3个月和6个月的LV体积和功能.
- 关键的入选标准:NYHA III/IV类,LVEF ≤35%,QRS持续时间 ≥150 ms.
主要成果:
- 所有节奏组都显示了LV末缩和末缩维度的显著减少.
- 同时进行BiV节奏测试表明,LV末缩维度 (P=0.007) 的最大降低.
- 在所有组中,中风体积和LV喷射率均有所改善,它们之间没有显著差异.
结论:
- 同时的BiV节奏与LV节奏相比,LV大小的改善趋势更大.
- 在这个试验中编程的同时BiV和顺序BiV节奏之间发现了最小的差异.
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