Wang Lexin
School of Biomedical Sciences, Charles Sturt University, Australia.
Exp Clin Cardiol. 2002 Winter;7(4):212-5.
Congestive heart failure (CHF) is one of the leading causes of morbidity and mortality worldwide. Up to 50% of CHF patients have intraventricular conduction disturbances such as left bundle branch block or nonspecific wide QRS complex on the body surface ECG. Intraventricular conduction delays cause dyssynchrony of the ventricles which in turn leads to regional movement abnormalities and worsening of cardiac function. Recent clinical trials have indicated that cardiac resynchronization therapy or biventricular pacing in CHF patients with left bundle branch block or wide QRS complex improves cardiac function class, exercise tolerance, maximum oxygen consumption and quality of life within the first 12 months of therapy. The number of hospitalizations and the use of intravenous medications for worsening heart failure are also reduced by this new therapy. Apart from the short to medium term clinical benefits, cardiac resynchronization therapy has not been shown to reduce overall cardiac mortality. The present article reviews the pathophysiology of ventricular dyssynchrony and evaluates the results of recent clinical trials on resynchronization therapy.
充血性心力衰竭（CHF）是全球发病和死亡的主要原因之一。高达50%的CHF患者存在室内传导障碍，如体表心电图上的左束支传导阻滞或非特异性宽QRS波群。室内传导延迟会导致心室不同步，进而导致局部运动异常和心功能恶化。最近的临床试验表明，对于患有左束支传导阻滞或宽QRS波群的CHF患者，心脏再同步治疗或双心室起搏可在治疗的前12个月内改善心功能分级、运动耐量、最大耗氧量和生活质量。这种新疗法还减少了因心力衰竭恶化而住院的次数以及静脉用药的使用。除了短期到中期的临床益处外，心脏再同步治疗尚未显示能降低总体心脏死亡率。本文综述了心室不同步的病理生理学，并评估了最近关于再同步治疗的临床试验结果。
