Kass David A
Division of Cardiology, Johns Hopkins Medical Institutions, Baltimore, Maryland 21205, USA.
J Am Coll Cardiol. 2008 Jan 1;51(1):12-7. doi: 10.1016/j.jacc.2007.09.027.
Cardiac resynchronization therapy (CRT) is used to treat a subset of heart failure patients with discoordinate wall motion. Defining appropriate patients is important, and, although electrical delay (wide QRS) is commonly used, recent data show that measures of mechanical dyssynchrony improve the sensitivity and specificity of predicting responders (including patients with narrow QRS complexes). This has stimulated studies of dyssynchrony per se, and the phenomenon now appears to be very common in virtually all forms of heart failure. However, what all this dyssynchrony means clinically, and how or whether it should be treated by CRT or other means, remains unclear.
心脏再同步治疗（CRT）用于治疗一部分存在不协调室壁运动的心力衰竭患者。确定合适的患者很重要，虽然电延迟（宽QRS波）常用，但近期数据表明，机械不同步的测量可提高预测反应者（包括QRS波窄的患者）的敏感性和特异性。这激发了对不同步本身的研究，现在这种现象在几乎所有形式的心力衰竭中似乎都很常见。然而，所有这些不同步在临床上意味着什么，以及是否应该通过CRT或其他方法进行治疗，仍不清楚。
