慢性心力衰竭中的设备治疗:心脏收缩度调节与心脏再同步治疗相比
Goekhan Yuecel1,2, Leo Gaasch1, Abbass Kodeih1
1Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
ESC heart failure
|September 30, 2024
概括
用除器 (CRT-Ds) 和心脏收缩度调制 (CCMs) 的心脏再同步治疗为心力衰竭患者提供了可比的功能改善. 然而,CCM患者的住院率较高,可能是由于植入时心力衰竭更为晚期.
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:
- 心脏植入式电气设备 (CRT-D,CCM) 是症状性心力衰竭 (HF) 的选择,尽管最佳的医疗治疗,但左心室喷射率 (LVEF) 降低.
- 在此之前,CRT-D和CCM之间的直接比较尚未建立.
研究的目的:
- 为了比较CRT-Ds与CCMs在患有症状心力衰竭和减少LVEF的患者的疗效和结果.
- 为了评估纽约心脏协会 (NYHA) 分类,LVEF,三状环状平面缩外流 (TAPSE) 和12个月后QRS宽度的变化.
主要方法:
- 在2012年至2021年期间接受CRT-Ds (n=220) 或CCMs与除器 (n=105) 的患者的回顾性分析.
- 基线特征和12个月后续数据的比较,包括NYHA,LVEF,TAPSE和QRS宽度.
- 对心力衰竭住院率的分析.
主要成果:
- 与CRT-D患者相比,CCM患者的基线LVEF较低,NYHA分类更差.
- 无论是CRT-D还是CCM,在12个月后,NYHA,LVEF和TAPSE都显示出可比的改善.
- 与CRT-D患者 (16.8%) 相比,CCM患者 (45.7%) 的HF住院病例显著增加.
结论:
- 两种CRT-D和CCM都在12个月内为心力衰竭患者提供了可比的功能状态和心室逆向重塑改善.
- 在CCM患者中,较高的HF住院率可能归因于他们在植入时更先进的HF.
- 适当植入CCM和CRT-D可以在选择的心力衰竭患者中产生类似的积极结果.
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