宽QRS与超声心动图心室结构改变的关系

心脏再同步治疗作为治疗心力衰竭一种手段,效果是肯定的。但是,仍有近1/3的病人不能从中获益。如何早期、准确及可靠的判断心脏的同步性成为心脏再同步治疗的前提。传统观点认为电机械不同步是其主要指标,但越来越多的实验数据提示机械不同步在此方面更显优越性。其主要包括了三个方面的内容：宽QRS在单独判断心脏不同步的局限性,超声心动图判断心脏不同步的新旧方法以及宽QRS与心脏结构改变关系。

Relationship Between Prolonged QRS and Heart Structural Changes

Cardiac resynchronization therapy is an established therapy for the heart failure patient.Unfortunately,nearly one-third of patients receiving this therapy fail to clinically improve.A reliable,accurate,and early detection system has yet to be created.In traditional assessments electrical dyssynchrony is one of the main criteria for determining eligibility for cardiac resynchronization therapy.This review discusses three aspects of the issue：（1） the limitation of wide QRS as the criteria for the determination for cardiac resynchronization therapy.（2） summarizes a practical update of old and new echocardiographic methods and measurements of inter-ventricular and intra-ventricular dyssynchrony.（3） describes the relationship between wide QRS and the changing ventricular structure.