心脏再同步治疗超反应的预测因素研究

目的 寻找心脏再同步治疗（CRT）超反应可能的预测因素.方法 将66例植入CRT的患者分为超反应组和非超反应组,通过组间比较、Logistic回归分析以及绘制受试者工作（ROC）曲线等方法寻找CRT超反应的独立预测因子,并评价其预测价值.结果 超反应患者中男性、右束支阻滞少,左束支阻滞多,植入术前左心室舒张末内径（LVEDD）小,术后QRS时限短,但只有术前LVEDD是CRT超反应的独立预测因子,术前LVEDD≤68.5 mm预测CRT超反应的敏感性为84.6%,特异性为76.9%.结论 植入术前左心室较小的CRT治疗患者更容易从这一器械治疗中获益.

Predictors of super-response to cardiac resynchronization therapy

Objective To investigate possible predictors of super-response to cardiac resynchronization therapy( CRT ). Methods Sixty-six patients with CRT were divided into group A (super-responders) and group B ( patients exclusive of super-responders). The independent predictors and their predictive value of super-response to CRT were evaluated by Logistic regression analysis and receiver operating characteristic curve between the two groups. Results There were few male patients,less right bundle branch block,more left bundle branch block,smaller pre-implant left ventricular end-diastolic dimension (LVEDD) and shorter post-implant QRS duration among the super-responders. But pre-implant LVEDD was the sole independent predictor. A pre-implant LVEDD of 68. 5 mm as the cut-off value identified super-responders with 84. 6% sensitivity and 76. 9% specificity. Conclusion CRT candidates with smaller left ventricular size are more likely to benefit from this device therapy.