Département des pathologies cardiaques congénitales du fœtus, de l'enfant et de l'adulte, hôpital cardiologique du Haut-Lévêque, CHU de Bordeaux, avenue de Magellan, 33604 Pessac cedex, France.
Arch Cardiovasc Dis. 2011 Jun-Jul;104(6-7):410-6. doi: 10.1016/j.acvd.2011.04.008. Epub 2011 Jul 2.
Adults with congenital heart lesions constitute a rapidly growing group of patients with cardiovascular disease. This nascent demographic phenomenon is creating major issues concerning the optimal management of these patients, in whom sudden death and progressive heart failure are predominant causes of death. Ventricular dyssynchrony appears to be very common in this population and can appear early in the history of the disease. Recently, cardiac resynchronization therapy (CRT) has emerged as a potential treatment option for patients with congenital heart disease (CHD). In this paper, we review the clinical evidence for the role of CRT in a number of different groups of patients with congenital heart lesions. In particular, we focus on whether there is a plausible mechanistic role for CRT and, if so, whether this results in acute and longer-term beneficial effects. We conclude that CRT shows promise as a potential treatment option for patients with CHD and ventricular impairment, but larger clinical outcome studies are required before definitive guidance can be issued.
成人先天性心脏病患者构成了心血管疾病患者中一个快速增长的群体。这种新兴的人口现象给这些患者的最佳管理带来了重大问题，在这些患者中，猝死和进行性心力衰竭是主要的死亡原因。心室不同步在这群人中似乎很常见，并且在疾病的早期就可能出现。最近，心脏再同步治疗（CRT）已成为先天性心脏病（CHD）患者的潜在治疗选择。在本文中，我们回顾了 CRT 在多种不同先天性心脏病患者群体中的作用的临床证据。特别是，我们专注于 CRT 是否具有合理的机械作用，如果有，是否会产生急性和长期的有益效果。我们得出结论，CRT 有望成为 CHD 和心室功能障碍患者的潜在治疗选择，但需要更大的临床结局研究，才能给出明确的指导。
