心力衰竭患者的适应性与传统心脏再同步治疗 (AdaptResponse): 全球前性随机对照试验
Bruce L Wilkoff1, Gerasimos Filippatos2, Christophe Leclercq3
1Cleveland Clinic, Cleveland, OH, USA.
Lancet (London, England)
|August 27, 2023
概括
与常规CRT相比,适应性心脏再同步治疗 (CRT) 在心力衰竭和左结枝阻塞的患者中没有显著改善结果. 这两种治疗都显示出较低的事件率,这表明该患者群的有效性.
科学领域:
- 心脏病学
- 医疗器械
- 临床试验
背景情况:
- 常规的心脏再同步疗法 (CRT) 用于心力衰竭患者的左束分支阻塞 (LBBB).
- 适应式CRT提供持续的自动优化,可能改善结果.
- 这项研究重点是心力衰竭,LBBB和完整的心房导电 (AV) 的患者.
研究的目的:
- 将适应性CRT与常规CRT的临床结果进行比较.
- 在特定的心力衰竭群体中评估适应性CRT的疗效和安全性.
主要方法:
- 这是一项全球性,前性,随机对照试验,涉及3617名患者.
- 患者被分配到适应性CRT或常规双心脏CRT中.
- 主要结局是所有死因或心力衰竭补偿的干预.
主要成果:
- 与传统CRT相比,自适应CRT没有显著降低主要结果 (HR 0. 89, p=0. 077).
- 适应性CRT的发生率为23. 5%,常规CRT的发生率为25. 7%.
- 与系统相关的不良事件在各组之间是相似的 (25. 0% vs 24. 3%).
结论:
- 在这种患者群体中,自适应式CRT与传统CRT没有显著的益处.
- 这两种CRT策略均显示出良好的结果,死亡率和心力衰竭失补率较低.
- 这些发现表明,心力衰竭,LBBB和完整的AV导电患者对CRT的反应强烈.
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