Naqvi Syed Yaseen, Jawaid Anas, Goldenberg Ilan, Kutyifa Valentina
Heart Research Follow-Up Program, Cardiology Division, University of Rochester Medical Center, 265 Crittenden Blvd., Box 653, Rochester, NY, 14642, USA.
Curr Heart Fail Rep. 2018 Oct;15(5):315-321. doi: 10.1007/s11897-018-0407-7.
Cardiac resynchronization therapy (CRT) is an effective treatment option for therapy-refractory mild to severe heart failure (HF) patients with reduced ejection fraction and left ventricular (LV) conduction delay. Multiple clinical trials have shown that CRT improves cardiac function and overall quality of life, as well as reduces HF hospitalizations, health care costs, and mortality.
Despite its effectiveness, the "non-response" rate to CRT is around 30%, remaining a major challenge that faces electrophysiologists and researchers. It has been recently suggested that the etiology of CRT non-response is multifactorial, and it requires a multifaceted approach to address it. In this focused review, we will summarize the definitions of CRT non-response, identify key factors for CRT non-response, and offer a simplified framework to address CRT non-response with the main goal of improving CRT outcomes.
心脏再同步治疗(CRT)是治疗射血分数降低且伴有左心室(LV)传导延迟的轻至重度难治性心力衰竭(HF)患者的有效治疗选择。多项临床试验表明,CRT可改善心脏功能和整体生活质量,同时减少HF住院率、医疗保健成本和死亡率。
尽管CRT有效,但其“无反应”率约为30%,这仍然是电生理学家和研究人员面临的主要挑战。最近有人提出,CRT无反应的病因是多因素的,需要多方面的方法来解决。在这篇重点综述中,我们将总结CRT无反应的定义,确定CRT无反应的关键因素,并提供一个简化的框架来解决CRT无反应问题,主要目标是改善CRT治疗效果。