Cleland J G F, Daubert J C, Erdmann E, Freemantle N, Gras D, Kappenberger L, Klein W, Tavazzi L
Department of Cardiology, Castle Hill Hospital, Castle Road, Cottingham, University of Hull, Kingston upon Hull, UK HU16 5JQ.
Eur J Heart Fail. 2005 Mar 2;7(2):205-14. doi: 10.1016/j.ejheart.2005.01.010.
Cardiac resynchronization therapy (CRT) is a promising new treatment for patients with heart failure and cardiac dyssynchrony. The CARE-HF study is a morbidity/mortality trial designed to provide conclusive evidence of the effects of CRT in patients with moderate to severe heart failure.
A description of the baseline characteristics of patients randomised in the CARE-HF trial.
813 Patients with predominantly NYHA class III (94%) heart failure were randomised in 82 centres. Their mean age was 65 (interquartile range [IQR] 59 to 72) years, 34% were aged >70 years and 27% were women. Thirty-eight percent of the patients had ischaemic heart disease. Mean heart rate was adequately controlled at 70 (IQR 60 to 78) bpm consistent with the use of beta-blockers. Supine systolic blood pressure was low at 117 (IQR 105 to 130) mm Hg. Eighty-eight percent of patients had a QRS > or =150 ms. Mean LV ejection fraction was 26% (IQR 22 to 29) and end-diastolic dimension was 7.2 (IQR 6.4 to 7.8) cm. Ninety-four percent of patients were receiving loop diuretics, 95% an ACE inhibitor or angiotensin receptor blocker (ARB), 72% a beta-blocker and 56% were taking spironolactone.
The patients enrolled in CARE-HF had moderately severe heart failure and cardiac dysfunction with evidence of cardiac dyssynchrony. The population appears at high risk of events despite pharmacological therapy and therefore appropriate for a trial of CRT.
心脏再同步治疗（CRT）是一种针对心力衰竭和心脏不同步患者的有前景的新疗法。CARE-HF研究是一项发病率/死亡率试验，旨在提供CRT对中重度心力衰竭患者疗效的确凿证据。
对CARE-HF试验中随机分组患者的基线特征进行描述。
813例主要为纽约心脏协会（NYHA）III级（94%）心力衰竭的患者在82个中心进行了随机分组。他们的平均年龄为65岁（四分位间距[IQR]为59至72岁），34%的患者年龄>70岁，27%为女性。38%的患者患有缺血性心脏病。平均心率通过使用β受体阻滞剂得到充分控制，为70次/分钟（IQR为60至78次/分钟）。仰卧位收缩压较低，为117毫米汞柱（IQR为105至130毫米汞柱）。88%的患者QRS≥150毫秒。平均左心室射血分数为26%（IQR为22至29），舒张末期内径为7.2厘米（IQR为6.4至7.8厘米）。94%的患者正在接受襻利尿剂治疗，95%接受血管紧张素转换酶抑制剂或血管紧张素受体阻滞剂（ARB）治疗，72%接受β受体阻滞剂治疗，56%正在服用螺内酯。
参与CARE-HF研究的患者患有中度严重心力衰竭和心脏功能障碍，并有心脏不同步的证据。尽管进行了药物治疗，该人群似乎仍有较高的事件风险，因此适合进行CRT试验。
