心脏再同步治疗的时间和指示的里程碑式发展:来自多中心回顾注册表的结果
Jeroen Bijnens1, Sander Trenson1,2,3,4, Gabor Voros1,4
1Department of Cardiology, University Hospitals Leuven, 3000 Leuven, Belgium.
Journal of clinical medicine
|April 13, 2024
概括
尽管植入率增加,心脏再同步治疗 (CRT) 的结果随着时间的推移保持稳定. 患者的特征,而不是CRT的进步,可能解释了心力衰竭患者持续的长期存活率.
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) 是广泛QRS的心力衰竭的标准.
- 长期结果数据和植入标准需要进一步调查.
- 在过去的二十年中,CRT经历了显著的进化和越来越多的采用.
研究的目的:
- 评估CRT的长期结果随着时间的推移.
- 分析CRT植入率和患者特征的趋势.
- 确定影响CRT疗效和患者存活率的因素.
主要方法:
- 对接受CRT (2000-2019) 的2275名患者进行了回顾性分析.
- 根据里程碑性试验和指导方针定义了四个时间段.
- 评估死亡率,心脏移植或LVAD植入的复合终点.
主要成果:
- 复合终点发生在29.2%的患者中.
- 在研究期间,每年的CRT植入率翻了三倍.
- 调整后的分析显示,各个时间段的复合终点危险比率稳定.
- 非LBBB模式和QRS持续时间<130毫秒与更高的危险比率有关.
结论:
- 尽管技术进步,CRT的整体存活率保持稳定.
- 患者特征的转变,而不是CRT创新,可能解释了稳定的结果.
- 非LBBB导电和更短的QRS持续时间表明CRT接受者的预后较差.
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