Department of Cardiology, University of Ferrara, S. Anna Hospital, Ferrara.
Cardiology Division, Department of Diagnostics, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy.
J Cardiovasc Med (Hagerstown). 2018 Jul;19(7):324-328. doi: 10.2459/JCM.0000000000000657.
: This is a systematic review of current evidence regarding the efficacy of cardiac resynchronization therapy (CRT) on patients with dilated cardiomyopathy and isolated left ventricular noncompaction (IVNC). This systematic review was performed following Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. Records were searched in Pubmed, Cochrane Library, Google Scholar, Biomed Central. We included only studies focused on ventricular noncompaction patients treated with CRT. Of 46 records screened, we included 14 studies involving a total of 70 patients. All studies showed a reduction of New York Heart Association class and an increase of the ejection fraction that ranges from 8 to 36% at follow-up after CRT. Analyzing the type of response to CRT, approximately 50% of the patients were classified as responders to the therapy and most of them were super-responders. In conclusion, CRT provides beneficial effects in terms of clinical status and left ventricular function on IVNC patients with heart failure. CRT responders seem to have a great left ventricular reverse remodeling supporting the theory that CRT is able to provide an additional benefit in the IVNC disease, improving the performance of IVNC segments, when paced.
这是一项关于心脏再同步治疗(CRT)对扩张型心肌病和孤立性左室心肌致密化不全(IVNC)患者疗效的现有证据的系统评价。本系统评价遵循系统评价和荟萃分析报告的首选条目。在 Pubmed、Cochrane 图书馆、Google Scholar、Biomed Central 中检索记录。我们只纳入了专注于接受 CRT 治疗的心室非致密化患者的研究。在筛选出的 46 条记录中,我们纳入了 14 项共涉及 70 名患者的研究。所有研究均显示 CRT 后随访时纽约心脏协会(NYHA)心功能分级降低,射血分数增加 8%至 36%。分析 CRT 的反应类型,约 50%的患者被归类为 CRT 治疗的反应者,其中大多数为超级反应者。总之,CRT 可改善心力衰竭的 IVNC 患者的临床状态和左心室功能。CRT 反应者似乎有很大的左心室逆重构,支持 CRT 能够在 IVNC 疾病中提供额外益处的理论,改善 IVNC 节段的功能,当起搏时。