心脏再同步治疗对逆重塑和结果关系的影响:多中心自动除器植入试验:心脏再同步治疗
Scott D Solomon1, Elyse Foster, Mikhail Bourgoun
1Cardiovascular Division, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115, USA. ssolomon@rics.bwh.harvard.edu
Circulation
|August 25, 2010
概括
心脏再同步疗法 (CRT) 结合可植入心脏转移器除器 (ICD) 显著改善心力功能和心力衰竭患者的体型. 这些积极的心声学变化与更好的长期结果有关,减少死亡或心力衰竭事件.
科学领域:
- 心脏病学 心脏病学
- 心脏衰竭管理的管理
- 医疗器械技术 医疗器械技术
背景情况:
- 用可植入心转动器除器 (ICD) 进行心脏再同步治疗 (CRT) 对轻度症状心力衰竭患者,左心室功能障碍和广QRS复合体有希望.
- 之前的研究表明,CRT加上ICD与单独的ICD相比,可以降低死亡或心力衰竭事件的风险.
研究的目的:
- 评估来自MADIT-CRT试验的患者的心声学变化.
- 为了确定CRT加ICD的结果改善是否与心脏大小和功能的有利变化有关.
主要方法:
- 1,820名患者被随机分配到CRT加ICD或单独ICD (3:2比).
- 在基线和12个月内,对1372名患者进行了心声图学研究.
- 组间对心脏大小和功能的变化进行了比较,并评估了它们与后续结果的关系.
主要成果:
- 与仅使用ICD的组相比,CRT加ICD组在左心室终端透气体积指数,左心室终端静脉体积指数,左心室排气分数,左心室体积指数和右心室分数面积变化方面表现出更大的改善.
- 一年后,终端透析体积减少10%与随后死亡或心力衰竭风险减少40%有关 (P<0.001).
结论:
- 与仅使用ICD的策略相比,CRT在轻度症状心力衰竭的患者中显著改善了心脏大小和性能.
- 观察到的心脏指标的改善反映了患者结局的好处.
相关概念视频
Pulse rhythm
1.7K
Pulse rhythm refers to the pattern of pulsations within specific intervals, offering valuable insights into the regularity or irregularity of the heart's beats as observed through the pattern of pulsation within specific intervals. A regular pulse exhibits a consistent heart rate with uniform waveforms and pulsation force, variations of which can be classified as normal, weak, or bounding.
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac...
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac...
1.7K
Coronary Artery Disease V: Interprofessional Care
452
Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
452
Heart Failure VI: Adjunct Therapies
635
Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
635
Cardiomyopathy II: Dilated Cardiomyopathy
802
Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
802
Cardiomyopathy III: Hypertrophic Cardiomyopathy
812
Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
812
Cardiomyopathy V: Interprofessional Care
762
Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
762


