Department of Cardiology, Anhui Provincial Hospital, No. 17 Lujiang Road, Hefei, 230001, China.
Cardiac Arrhythmia center, Fuwai Hospital, Chinese Academy of medical Sciences, No. 167 North Lishi Road, Beijing, 100037, China.
Sci Rep. 2018 Mar 9;8(1):4259. doi: 10.1038/s41598-018-22525-0.
In this trial, long-term therapeutic effects and clinical improvements in Chinese chronic heart failure patients optimized by QuickOpt or echocardiography were compared for atrioventricular (AV) and interventricular (VV) delay optimizations after cardiac resynchronization therapy (CRT) with pacing (CRT-P) or with pacing and defibrillator (CRT-D) therapy. One hundred and ninety-six subjects (50%) had dilated cardiomyopathy, 108 (27.6%) had ischemic heart disease and 112 (28.6%) were hypertensive and were randomized into QuickOpt (198) or echocardiographic optimization (control) (194) groups at ≤2-weeks post-implantation. Programmed AV/VV delay was optimized at baseline and at 3 and 6 months. Left ventricular end-systolic volume (LVESV), New York Heart Association (NYHA) class, specific activity scale (SAS), and the six-minute walk tests (6MWT) were evaluated by blinded researchers at 12 months. Of the QuickOpt group, LVESV decreased significantly by 24.7% ± 33.9% compared with baseline, while LVESV of Controls decreased by 25.1% ± 36.1% (P = 0.924). NYHA class, SAS and 6MWT also improved similarly in both groups at 12 months. Mortality in both groups was not significantly different (11.0% vs 7.6%, P = 0.289). However, there was a significant difference in the time required for optimization by QuickOpt compared with echocardiography (3.33 ± 3.11 vs 58.79 ± 27.03 minutes, P < 0.000).
在这项试验中,比较了使用 QuickOpt 或超声心动图对心脏再同步治疗(CRT)后房室(AV)和室间(VV)延迟进行优化的中国慢性心力衰竭患者的长期治疗效果和临床改善情况,这些患者接受的是起搏(CRT-P)或起搏和除颤(CRT-D)治疗。196 名受试者(50%)患有扩张型心肌病,108 名(27.6%)患有缺血性心脏病,112 名(28.6%)患有高血压,他们在植入后≤2 周时被随机分为 QuickOpt(198 名)或超声心动图优化(对照组)(194 名)组。在基线和 3 个月和 6 个月时优化程控 AV/VV 延迟。由盲法研究者在 12 个月时评估左心室收缩末期容积(LVESV)、纽约心脏协会(NYHA)分级、特定活动量表(SAS)和 6 分钟步行测试(6MWT)。与基线相比,QuickOpt 组的 LVESV 显著下降 24.7%±33.9%,而对照组的 LVESV 下降 25.1%±36.1%(P=0.924)。两组在 12 个月时 NYHA 分级、SAS 和 6MWT 也均有相似改善。两组的死亡率无显著差异(11.0%比 7.6%,P=0.289)。然而,QuickOpt 与超声心动图相比,优化所需的时间有显著差异(3.33±3.11 分钟比 58.79±27.03 分钟,P<0.000)。