在心力衰竭患者中,左束枝节奏对左束枝节奏的中期反应的决定因素左束枝节阻塞患者
Yang Ye1, Yu Zhang2, Yankai Mao3
1Key Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang Province, Department of Cardiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
The Canadian journal of cardiology
|July 5, 2025
概括
左束枝节奏 (LBBP) 改善了LBBB的非缺血性心肌病患者的QRS持续时间. 然而,较大的左心室末期透析体积和心肌糖摄取量减少预测LBBP无反应.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 核医学是一种核医学.
背景情况:
- 左捆枝节奏 (LBBP) 响应在左捆枝阻塞 (LBBB) 患者中有所不同.
- 患有LBBB的非缺血性心肌病 (NICM) 患者对节拍治疗构成挑战.
- 了解影响LBBP反应的因素对于优化患者的治疗结果至关重要.
研究的目的:
- 为了研究临床响应LBBP和心室电活动,体积和心肌葡萄糖摄取在NICM患者与LBBB.之间的关联.
- 为了确定该患者群体中对LBBP无反应的预测因素.
主要方法:
- 潜在的连续NICM患者的入学LBBB接受LBBP.
- 测量心电 QRS 持续时间 (QRSd) 和左心室体积.
- 使用F-氧糖 (F-fluorodeoxyglucose,FDG) 定子发射断层扫描 (PET) 评估心肌糖吸收,分析标准化吸收值 (SUV) 和目标与背景比率 (TBR).
主要成果:
- 在所有患者中,LBBP显著降低了QRSd,但33%的患者在6个月后没有显著的临床反应.
- 与响应者相比,非响应者具有类似的QRSd减少.
- 多变量分析确定了较大的左心室终端透缩体积 (LVEDV) 和下隔膜心肌糖摄取 (TBR平均隔膜) 作为LBBP不响应的预测因素.
结论:
- 在LBBB的NICM患者中,LBBP有效地缩短了QRSd.
- 对LBBP的临床反应是可变的,与基线LVEDV和心肌葡萄糖代谢受损相关的无反应.
- 室腔电失调,心脏体积和心肌代谢是选择LBBB患者节奏治疗的重要考虑因素.
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