Delgado Reynolds M, Radovancevic Branislav
The Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, Texas 77225-0345, USA.
Heart Fail Clin. 2007 Jul;3(3):259-65. doi: 10.1016/j.hfc.2007.05.004.
In patients who have end-stage heart failure, medical therapy is of limited use, and heart transplantation is frequently not an option because of the shortage of donor hearts. Two new treatment options, left ventricular assist devices (LVADs) and implantable cardiac resynchronization therapy (CRT) devices, can improve survival and quality of life in patients who have heart failure. Both types of devices are easy to implant. However, LVADs carry the risk of infection and mechanical failure, and CRT is ineffective in a substantial proportion of patients who have heart failure. Therefore, methods must be devised to identify patients who have heart failure who are likely to benefit from these devices. Data suggest that early LVAD implantation, before end-stage heart failure develops, is critical to slowing or reversing disease progression. Similarly, in indicated patients who have less advanced disease, CRT may be particularly beneficial.
对于终末期心力衰竭患者，药物治疗作用有限，且由于供体心脏短缺，心脏移植往往并非可行选择。两种新的治疗选择，即左心室辅助装置（LVAD）和植入式心脏再同步治疗（CRT）装置，可改善心力衰竭患者的生存率和生活质量。这两种装置都易于植入。然而，LVAD有感染和机械故障风险，且CRT对相当一部分心力衰竭患者无效。因此，必须设计方法来识别可能从这些装置中获益的心力衰竭患者。数据表明，在终末期心力衰竭发展之前尽早植入LVAD对于减缓或逆转疾病进展至关重要。同样，在病情较轻的特定患者中，CRT可能特别有益。
