Tuccillo Bernardino, Muto Carmine, Iengo Raffaele, Accadia Maria, Rumolo Salvatore, Canciello Micheleangelo, Carreras Giovanni, Calvanese Raimondo, Celentano Eduardo, Davinelli Mario, Valsecchi Sergio, Ascione Luigi
Santa Maria di Loreto Mare Hospital, Naples, Italy.
J Interv Card Electrophysiol. 2008 Nov;23(2):121-6. doi: 10.1007/s10840-008-9255-9. Epub 2008 Jun 28.
We evaluated whether the dobutamine stress-echo test can select responders to cardiac resynchronization therapy (CRT). Up to 50% of patients do not respond to CRT. Lack of response may be due to a significant amount of scar or fibrotic tissue at myocardial level.
We studied 42 CRT patients. After clinical and echocardiographic evaluation, all patients underwent a dobutamine stress-echo test to assess contractile reserve. Cut-off for the test was an increase of 25% of the left ventricular ejection fraction. Patients were implanted with a CRT-defibrillator and followed up at 6 months. Cut-off for CRT response was a reduction of 15% of left ventricular end-systolic volume. Twenty-five patients responded to CRT; all of them showed presence of contractile reserve. The test showed a sensitivity of 100% and a specificity of 88%.
Contractile reserve was a strong predictive factor of response to CRT in the studied population.
我们评估了多巴酚丁胺负荷超声心动图试验能否筛选出心脏再同步化治疗（CRT）的反应者。高达50%的患者对CRT无反应。无反应可能是由于心肌层面存在大量瘢痕或纤维化组织。
我们研究了42例CRT患者。经过临床和超声心动图评估后，所有患者均接受了多巴酚丁胺负荷超声心动图试验以评估收缩储备。该试验的截断值为左心室射血分数增加25%。患者植入了CRT除颤器并随访6个月。CRT反应的截断值为左心室收缩末期容积减少15%。25例患者对CRT有反应；他们均显示有收缩储备。该试验的敏感性为100%，特异性为88%。
在研究人群中，收缩储备是对CRT反应的一个强有力的预测因素。
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