植入式心脏转换器除器和心脏再同步治疗
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
概括
心脏再同步治疗 (CRT) 改善了心力衰竭患者的治疗结果. 目前的指导方针建议在有症状和轻度症状的患者中进行CRT,并正在研究扩展的指示和优化策略.
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:
- 植入式心脏转换器除器和心脏再同步治疗 (CRT) 是心力衰竭的标准治疗方法.
- 证据支持在有症状 (NYHA III类) 和轻微症状 (NYHA II类) 的心力衰竭患者中使用CRT有好处.
研究的目的:
- 在CRT上批判性地评估里程碑式的随机临床试验 (REVERSE,MADIT-CRT,RAFT).
- 讨论CRT新出现的指示,包括特定的患者子组和优化.
主要方法:
- 对具有里程碑意义的随机临床试验进行审查和批判性评估.
- 讨论扩大CRT指示和患者反应的证据.
主要成果:
- 建议对NYHAII和III类心力衰竭患者进行CRT.
- 有证据支持在轻度减少LVEF和狭窄QRS的患者中探索CRT.
结论:
- 对于更广泛的患者群体来说,CRT是心力衰竭管理的基石.
- 进一步的研究和优化对于非响应者和提高CRT疗法的有效性至关重要.
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