心脏再同步治疗晚期扩张型心肌病的临床研究

目的 探讨心脏再同步治疗（CRT）治疗扩张型心肌病（DCM）晚期慢性心力衰竭（HF）的疗效。方法DCM晚期发生慢性HF患者植入CRT。术后观察左室射血分数（LVEF）、左室舒张末内径（LVEDD）、心电图、NT—ProBNP，评估NYHA心功能分级，6min步行试验。结果所有患者均成功地植入右房-双心室三腔起搏器，并且无术后并发症。术后随访6～12个月心功能分级、LVEF、LVEDD、房室瓣反流速、NT—ProBNP水平、QRS波宽度较术前均明显改善，差异有统计学意义（P〈0．05）。结论CRT可以改善心功能，逆转左室重构，改善生活质量。

Effect of Cardiac Resynchronization Therapy on 45 Patients with Dilated Cardiomyopathy

Objective To investigate the effect of cardiac resynchronization therapy(CRT) on 45 patients with dilated cardiomyopathy(DCM).Methods Torty-five patients with DCM were inplanted with synchronous biventricular pacemakers,All patients had NYHA class Ⅲ to Ⅳ heart failure with ejection fraction(LVEF)(27.8±4.9)%,left ventriular end-diastolic diameter(LVEDD)(68.2±9.4)mm,and QRS duration of(152.9±14.3) m sec.the return speed of insufficiency(4.0±0.6)m/sec,the experiment of 6 minute′s walking(199.2±99.7)m.Serial assessment was performed before and after pacing.Results After a follow-up period of 6-12 months,there were significant inprovements of QRS duration decreased to(134.4±11.2) m sec,NYHA class of heart function from(3.49±0.5) to(1.8±0.4).LVEF increased from(27.8±4.9)% to(37.1±4.0)%(P<0.01),LVEDD decreased from(68.2±9.4)mm to(50.7±7.0)mm(P<0.01).NT-proBNP decreased from(8071.4±3024.4)pg/ml to(558.8±295.0)pg/ml.Conclusion CRT can reverse left ventricular remodeling and improve heart function,raise quality of life.