双心室起搏治疗充血性心力衰竭的长期益处：心肌病多部位刺激（MUSTIC）研究结果
Long-term benefits of biventricular pacing in congestive heart failure: results from the MUltisite STimulation in cardiomyopathy (MUSTIC) study.
作者信息
Linde Cecilia, Leclercq Christophe, Rex Steve, Garrigue Stephane, Lavergne Thomas, Cazeau Serge, McKenna William, Fitzgerald Melissa, Deharo Jean-Claude, Alonso Christine, Walker Stuart, Braunschweig Frieder, Bailleul Christophe, Daubert Jean-Claude
机构信息
Department of Cardiology, Karolinska Hospital, Stockholm, Sweden.
出版信息
J Am Coll Cardiol. 2002 Jul 3;40(1):111-8. doi: 10.1016/s0735-1097(02)01932-0.
OBJECTIVES
The main objective of this study was to assess if the benefits of biventricular (BiV) pacing observed during the crossover phase were sustained over 12 months.
BACKGROUND
MUltisite STimulation In Cardiomyopathies (MUSTIC) is a randomized controlled study intended to evaluate the effects of BiV pacing in patients with New York Heart Association (NYHA) class III heart failure and intraventricular conduction delay.
METHODS
Of 131 patients included, 42/67 in sinus rhythm (SR) and 33/64 in atrial fibrillation (AF) were followed up longitudinally at 9 and 12 months by 6-min walked distance, peak oxygen uptake (peak VO(2)), quality of life by the Minnesota score, NYHA class, echocardiography, and left ventricular ejection fraction by radionuclide technique.
RESULTS
At 12 months, all SR and 88% of AF patients were programmed to BiV pacing. Compared with baseline, the 6-min walked distance increased by 20% (SR) (p = 0.0001) and 17% (AF) (p = 0.004); the peak VO(2) by 11% (SR) and 9% (AF); quality of life improved by 36% (SR) (p = 0.0001) and 32% (AF) (p = 0.002); NYHA class improved by 25% (SR) (p = 0.0001) and 27% (AF) (p = 0.0001). The ejection fraction improved by 5% (SR) and 4% (AF). Mitral regurgitation decreased by 45% (SR) and 50% (AF).
CONCLUSIONS
The clinical benefits of BiV pacing appeared to be significantly maintained over a 12-month follow-up period.
目的
本研究的主要目的是评估在交叉阶段观察到的双心室（BiV）起搏的益处是否能持续12个月。
背景
心肌病多部位刺激（MUSTIC）是一项随机对照研究，旨在评估BiV起搏对纽约心脏协会（NYHA）III级心力衰竭和室内传导延迟患者的影响。
方法
在纳入的131例患者中，对42/67例窦性心律（SR）患者和33/64例心房颤动（AF）患者在9个月和12个月时进行纵向随访，随访指标包括6分钟步行距离、峰值摄氧量（峰值VO₂）、明尼苏达评分评估的生活质量、NYHA分级、超声心动图以及放射性核素技术测定的左心室射血分数。
结果
在12个月时，所有SR患者和88%的AF患者被程控为BiV起搏。与基线相比，6分钟步行距离增加了20%（SR）（p = 0.0001）和17%（AF）（p = 0.004）；峰值VO₂增加了11%（SR）和9%（AF）；生活质量改善了36%（SR）（p = 0.0001）和32%（AF）（p = 0.002）；NYHA分级改善了25%（SR）（p = 0.0001）和27%（AF）（p = 0.0001）。射血分数提高了5%（SR）和4%（AF）。二尖瓣反流减少了45%（SR）和50%（AF）。
结论
在12个月的随访期内，BiV起搏的临床益处似乎得到了显著维持。
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