动态优化AV/VV间期心脏再同步治疗慢性心力衰竭的临床观察

目的: 观察动态优化AV/VV间期心脏再同步治疗（cardiac resynchronization therapy，CRT）治疗慢性心力衰竭（CHF）的短中期疗效。方法: 12例CHF晚期患者接受CRT治疗，分别于植入前、植入术后3、6个月在超声心动图指导下优化房室（AV）间期和室室（VV）间期，同时观察心腔结构、二尖瓣返流及心电图、脑钠尿肽（BNP）检查等，评价CRT临床疗效。结果: 最佳优化AV间期120～180（158±19）ms和VV间期4～28（16±7）ms，临床症状改善，六分钟步行距离由(257±23)m增加至(344±21)m，QRS时限由（136±17）ms降至(109±12)ms(P<0.01,P<0.05)。植入后左室舒张末内径（LVEDD）较植入前明显缩小［(71±10) mm vs. (54±4),P<0.05］; 左室射血分数（LVEF）提高［(0.308±0.022) vs. (0.531±0.085),P<0.01］；血浆BNP值由植入前（876±415）ng/L降至(70±28)ng/L(P<0.05)。结论: 动态程控AV/VV间期可以提高CRT对CHF患者短、中期疗效。

Short-and mid-term clinical effectiveness of cardiac resynchronization therapy optimized AV/VV delay dynamically for patients with congestive heart failure

AIM: To observe the short-term and mid-term clinical effectiveness of cardiac resynchronization therapy(CRT) optimized AV/VV delay dynamically for patients with congestive heart failure(CHF).METHODS: Twelve patients with refractory heart failure received CRT device implantation.Pacing parameters were tested and AV/VV interval was optimized by the guidance of echocardiography during the follow-up period.The effectiveness of CRT was evaluated in terms of echocardiography,tissue Doppler,ECG and BNP during the ...