心脏再同步治疗对患有左心室辅助装置的患者的影响
Miloud Cherbi1, Vincent Galand2, Erwan Flecher3
1From the Cardiology Department, Toulouse University Hospital, Toulouse, France.
概括
在使用左心室辅助器件 (LVAD) 的患者中,心脏再同步治疗 (CRT) 没有改善存活率或减少心室失常 (VAs). 该研究发现没有显著的益处,一些患者经历了设备并发症.
科学领域:
- 心脏病学 心脏病学
- 医疗器械 医疗器械
- 临床研究 临床研究
背景情况:
- 许多使用左心室辅助装置 (LVAD) 的患者也接受心脏再同步治疗 (CRT).
- 在LVAD接受者中,CRT对存活率和心室节律失常 (VAs) 的影响尚不清楚.
研究的目的:
- 评估CRT和LVAD患者的生存结果之间的关联.
- 评估CRT对死亡率和VA发病率的影响.
主要方法:
- 分析来自多中心ASSIST-ICD注册表的患者.
- 使用1:1倾向分数匹配的652名LVAD接受者的队列.
- 评估了全因死亡率,心血管/非心血管死亡率和早期/晚期VA.
主要成果:
- 使用CRT与改善的生存率没有关联 (HR: 1.31 [0.94-1.82]).
- 没有发现与心血管死亡率 (HR: 1.14 [0.68-1.90]) 或非心血管死亡率 (HR: 0.88 [0.56-1.40]) 有意义的关联.
- CRT并没有降低早期 (OR:0.71 [0.43-1.16]) 或晚期 (OR:1.24 [0.73-2.11]) VAs的发生率,并且13.6%的CRT患者有与设备相关的并发症.
结论:
- 同时使用CRT与LVAD似乎没有提供生存益处.
- 这些发现表明,在LVAD的CRT患者中,与设备相关的并发症相关的潜在风险.
- 需要进一步的随机试验来澄清先前存在的CRT在LVAD接受者的作用.
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