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[窄QRS波群与运动能力受影响较小情况下的心脏再同步化]

[Cardiac resynchronization in narrow QRS and less affected exercise capacity].

作者信息

Stockburger M

机构信息

Medizinische Klinik mit Schwerpunkt Kardiologie, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Deutschland.

出版信息

Herzschrittmacherther Elektrophysiol. 2011 Mar;22(1):16-20. doi: 10.1007/s00399-011-0118-1.

DOI:10.1007/s00399-011-0118-1
PMID:21344232
Abstract

Cardiac resynchronization (CRT) through atrio-biventricular pacemaker therapy is now a well established treatment option for severely symptomatic patients with advanced systolic heart failure (HF) and intraventricular conduction delay, especially left bundle branch block. The purpose of this article is to address possible applications of biventricular pacing beyond the classical CRT indication. In particular, a summary is given of available information on CRT in patients with symptomatic systolic HF, but narrow QRS complex, and those with wide QRS, but less pronounced or even absent clinical HF signs.

摘要

通过房室双腔起搏器治疗进行心脏再同步化(CRT)目前是晚期收缩性心力衰竭(HF)且存在室内传导延迟、尤其是左束支传导阻滞的严重症状患者的一种成熟治疗选择。本文旨在探讨双心室起搏在经典CRT适应证之外的可能应用。特别是,总结了有关有症状收缩性HF但QRS波群窄的患者以及QRS波群宽但临床HF体征不明显甚至不存在的患者中CRT的现有信息。

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本文引用的文献

1
Cardiac-resynchronization therapy for mild-to-moderate heart failure.心脏再同步治疗轻中度心力衰竭。
N Engl J Med. 2010 Dec 16;363(25):2385-95. doi: 10.1056/NEJMoa1009540. Epub 2010 Nov 14.
2
Association of intraventricular mechanical dyssynchrony with response to cardiac resynchronization therapy in heart failure patients with a narrow QRS complex.左心室机械不同步与 QRS 波群狭窄的心力衰竭患者心脏再同步治疗反应的相关性。
Eur Heart J. 2010 Dec;31(24):3054-62. doi: 10.1093/eurheartj/ehq334. Epub 2010 Sep 23.
3
Left ventricular mechanical dyssynchrony by phase analysis of gated single photon emission computed tomography in end-stage renal disease.
门控单光子发射计算机断层扫描相位分析检测终末期肾病患者左心室机械不同步。
Am J Cardiol. 2010 Oct 1;106(7):1042-7. doi: 10.1016/j.amjcard.2010.05.039.
4
2010 Focused Update of ESC Guidelines on device therapy in heart failure: an update of the 2008 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure and the 2007 ESC guidelines for cardiac and resynchronization therapy. Developed with the special contribution of the Heart Failure Association and the European Heart Rhythm Association.2010年欧洲心脏病学会心力衰竭器械治疗指南重点更新:2008年欧洲心脏病学会急慢性心力衰竭诊断和治疗指南及2007年欧洲心脏病学会心脏再同步化治疗指南的更新。由心力衰竭协会和欧洲心律协会特别贡献制定。
Eur Heart J. 2010 Nov;31(21):2677-87. doi: 10.1093/eurheartj/ehq337. Epub 2010 Aug 27.
5
Fragmented QRS complexes are associated with cardiac fibrosis and significant intraventricular systolic dyssynchrony in nonischemic dilated cardiomyopathy patients with a narrow QRS interval.在QRS间期狭窄的非缺血性扩张型心肌病患者中,碎裂QRS波群与心脏纤维化及显著的室内收缩不同步相关。
Echocardiography. 2011 Jan;28(1):62-8. doi: 10.1111/j.1540-8175.2010.01242.x.
6
Prevention of disease progression by cardiac resynchronization therapy in patients with asymptomatic or mildly symptomatic left ventricular dysfunction: insights from the European cohort of the REVERSE (Resynchronization Reverses Remodeling in Systolic Left Ventricular Dysfunction) trial.心脏再同步治疗对无症状或轻度症状性左心室功能不全患者疾病进展的预防作用:来自欧洲队列的REVERSE(收缩期左心室功能不全再同步逆转重塑)试验的见解
J Am Coll Cardiol. 2009 Nov 10;54(20):1837-46. doi: 10.1016/j.jacc.2009.08.011. Epub 2009 Oct 1.
7
Slow wall motion rather than electrical conduction delay underlies mechanical dyssynchrony in postinfarction patients with narrow QRS complex.在 QRS 波群狭窄的心肌梗死后患者中,机械不同步的基础是缓慢的壁运动而非电传导延迟。
J Cardiovasc Electrophysiol. 2010 Jan;21(1):70-7. doi: 10.1111/j.1540-8167.2009.01579.x. Epub 2009 Sep 1.
8
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N Engl J Med. 2009 Oct 1;361(14):1329-38. doi: 10.1056/NEJMoa0906431. Epub 2009 Sep 1.
9
Cardiac resynchronization therapy in patients with a narrow QRS.窄QRS波患者的心脏再同步治疗
Curr Heart Fail Rep. 2009 Mar;6(1):49-56. doi: 10.1007/s11897-009-0009-5.
10
Randomized trial of cardiac resynchronization in mildly symptomatic heart failure patients and in asymptomatic patients with left ventricular dysfunction and previous heart failure symptoms.轻度症状性心力衰竭患者以及无症状左心室功能不全且既往有心力衰竭症状患者心脏再同步化治疗的随机试验。
J Am Coll Cardiol. 2008 Dec 2;52(23):1834-1843. doi: 10.1016/j.jacc.2008.08.027. Epub 2008 Nov 7.