Shanks Miriam, Delgado Victoria, Bax Jeroen J
University of Alberta, Mazankowski Alberta Heart Institute, Edmonton (Canada) and Heart Lung Center, Leiden University Medical Center, Leiden (The Netherlands).
J Atr Fibrillation. 2016 Feb 29;8(5):1362. doi: 10.4022/jafib.1362. eCollection 2016 Feb-Mar.
Cardiac resynchronization therapy (CRT) is an established therapy for heart failure patients who remain symptomatic despite optimal medical therapy, have reduced left ventricular ejection fraction (<35%) and wide QRS duration (>120 ms), preferably with left bundle branch block morphology. The response to CRT depends on the cardiac substrate: presence of correctable left ventricular mechanical dyssynchrony, presence of myocardial fibrosis (scar) and position of the left ventricular pacing lead. Patients with non-ischemic cardiomyopathy have shown higher response rates to CRT compared with patients with ischemic cardiomyopathy. Differences in myocardial substrate may partly explain this disparity. Multimodality imaging plays an important role to assess the cardiac substrate and the pathophysiological determinants of response to CRT.
心脏再同步治疗（CRT）是一种针对尽管接受了最佳药物治疗仍有症状、左心室射血分数降低（<35%）且QRS波时限增宽（>120毫秒）、最好呈左束支传导阻滞形态的心力衰竭患者的既定治疗方法。CRT的疗效取决于心脏基质：可纠正的左心室机械不同步的存在、心肌纤维化（瘢痕）的存在以及左心室起搏导线的位置。与缺血性心肌病患者相比，非缺血性心肌病患者对CRT的反应率更高。心肌基质的差异可能部分解释了这种差异。多模态成像在评估心脏基质和CRT反应的病理生理决定因素方面发挥着重要作用。
