在心力衰竭中,左束分支节奏与双节奏的长期结果:HeartSync-LBBP随机临床试验
Xueying Chen1,2,3,4,5, Xi Liu1,2,3,4,5, Ruogu Li6
1Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China.
JAMA cardiology
|March 11, 2026
概括
与双心脏节奏节奏节奏 (BiVP) 相比,左捆枝节节奏节奏 (LBBP) 在左捆枝节阻塞 (LBBB) 患者中显著降低了死亡或心力衰竭住院的风险. 这一发现为心力衰竭管理提供了一种优越的替代方案.
科学领域:
- 心脏病学 心脏病学
- 电力生理学 电力生理学
- 心脏衰竭管理的管理
背景情况:
- 左束支节节奏 (LBBP) 是对心脏衰竭患者的双心脏支节节奏 (BiVP) 的潜在替代方案,患者患有左束支节阻塞 (LBBB).
- 从比较LBBP和BiVP的随机试验中获得的强有力的临床证据有限.
研究的目的:
- 评估和比较LBBP与BiVP在LBBB和左心室喷射率 (LVEF) 减少的患者中的长期临床结果.
主要方法:
- 一个多中心,前性,随机临床试验,涉及200名患者,LVEF≤35%和LBBB.
- 患者被随机分配1:1接受LBBP或BiVP.
- 主要终点:所有死因或心力衰竭住院治疗 (HFH) 的时间.
主要成果:
- 与BiVP相比,LBBP表现出主要终点 (死亡或HFH) 的比率明显较低 (8%与28%,P <.001).
- LBBP显著降低了HFH的风险 (7.0%与28.0%,P<.001),但没有显示出任何原因死亡率的显著差异.
- 较高的超级反应率 (LVEF增加≥15%或LVEF≥50%) 被观察到与LBBP (55.0%对比36.0%,P<.007).
结论:
- 在降低LBBB和严重降低LVEF的患者死亡或HFH风险方面,LBBP优于BiVP.
- 此外,LBBP还促进了LVEF的更大改进.
- 需要进一步的临床试验来证实这些发现在这个患者群体.
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