心脏再同步治疗与除器在缺血与非缺血性心肌病的治疗
Goekhan Yuecel1,2, Leo Gaasch1, Svetlana Hetjens3
1Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University.
International heart journal
|September 29, 2024
概括
用可植入心脏转换器除器 (CRT-Ds) 进行心脏再同步治疗可以改善心力衰竭的结果. 长期功能状态和重塑的好处被观察到,无论心力衰竭是缺血还是非缺血.
科学领域:
- 心脏病学 心脏病学
- 医疗器械 医疗器械
背景情况:
- 植入式心脏转换器除器 (CRT-Ds) 的心脏再同步治疗是心力衰竭 (HF) 的标准治疗方法.
- 在CRT-D植入后的高频变异中,长期结果和由病因学决定的差异需要进一步研究.
研究的目的:
- 在患有缺血性心肌病 (ICM) 和非缺血性心肌病 (NICM) 的患者中,比较CRT-D治疗的长期结果.
- 评估HF修饰的病因依赖差异,包括存活率,左心室喷射率 (LVEF) 和住院病例.
主要方法:
- 曼海姆心脏再同步治疗疗法的回顾性分析回顾性观察AtioNAl (MARACANA) 注册 (2013-2021年).
- 对380名CRT-D接受者进行比较,分为ICM (n=206) 和NICM (n=174),基于生存率,LVEF,HF住院,QRS宽度和NYHA分类,平均随访时间为59.1个月.
主要成果:
- 患有ICM的患者年龄较大,主要是男性,在基线时具有较高的肌素水平.
- 在NICM组中,平均存活时间更好 (54.4个月与51.9个月).
- 两组在NYHA分类和LVEF中都显示出类似的长期改善. 在第一年内,ICM患者有更多的HF住院,而NICM患者则表现出更显著的电气改造.
结论:
- 对于心力衰竭患者来说,CRT-D疗法在功能状态和左心室逆向重塑方面提供了长期的好处,而不管潜在的病因.
- 与时间和病因相关的并发症可能会影响CRT-D植入后HF修改的特定方面.
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