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在响应心脏再同步治疗后的后期阶段,左心室缩功能下降

Tomoya Iwawaki¹, Yasuya Inden¹, Satoshi Yanagisawa²

¹Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.

|February 8, 2025

概括

一些心力衰竭患者最初对心脏再同步治疗 (CRT) 有反应,但后来心脏功能下降,称为延迟负反向重塑 (DNRR). 识别DNRR预测因子可以改善长期患者的治疗结果.

科学领域:

心脏病学心脏病学
心脏衰竭管理的管理
心脏电生理学心脏电生理学

背景情况:

心脏再同步疗法 (CRT) 是有效的心力衰竭 (HF) 与异步.
一组CRT反应者经历左心室 (LV) 缩功能延迟下降,称为延迟负反向重塑 (DNRR).

研究的目的:

为了研究CRT响应者的DNRR特征.
为了确定与DNRR相关的预后.
为了确定DNRR的预测因素.

主要方法:

对203名接受CRT植入的患者进行分析.
根据6个月后的LV喷射分数 (LVEF) 和LV末缩体积变化,确定了100名响应者.
定义DNRR是LVEF在应答后1年内绝对下降≥5%.

主要成果:

22%的CRT受访者发展了DNRR,显示了显著的LVEF下降.
DNRR与更糟糕的结果有关,包括心脏病死亡和HF住院治疗.
DNRR的独立预测因素包括LV末缩体积≥100毫升,步调QRS持续时间≥150毫秒,同步LV步调率<85%和心室内导电干扰.

结论:

延迟负反转改造 (DNRR) 在CRT响应者的子集中发生,与较差的临床结果相关.
识别DNRR的风险因素对于优化CRT管理至关重要.
进一步的研究可以改善DNRR患者的长期护理.

关键词:

心脏再同步治疗心脏再同步治疗延迟的负反向改造延迟的负反向改造心脏衰竭是因为心脏衰竭.响应响应响应同步的左心室节奏.

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