Bonhorst Daniel, Guerreiro Sara, Fonseca Cândida, Cardim Nuno, Macedo Filipe, Adragão Pedro
Instituto Português do Ritmo Cardíaco, Porto Salvo, Portugal.
Serviço de Cardiologia, Hospital da Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Portugal.
Rev Port Cardiol (Engl Ed). 2019 Jan;38(1):33-41. doi: 10.1016/j.repc.2018.04.011. Epub 2019 Jan 23.
The aim of this study was to document clinical practice in Portugal regarding the use of electronic cardiac devices in patients with heart failure (HF) and reduced left ventricular ejection fraction (LVEF).
The Síncrone study was an observational prospective multicenter registry conducted in 16 centers in Portugal between 2006 and 2014. It included adult patients with a diagnosis of HF, LVEF <35% and indication for implantable cardioverter-defibrillator (ICD) and/or cardiac resynchronization therapy (CRT) devices, according to the recommendations of the European Society of Cardiology at the beginning of the study. Patients were followed for one year according to the practice of each center.
A total of 486 patients were included in the registry, half of whom received an ICD and the other half a CRT pacemaker (CRT-P) or CRT defibrillator (CRT-D). Mean age was 65±12 years and the most frequent causes of HF were ischemic (47%) and idiopathic dilated cardiomyopathy (28%). Overall mortality at one year was 3.6% and the hospitalization rate was 11%, significantly higher in patients with CRT-P/CRT-D than with ICD (17% vs. 5.6%, p<0.001). Patients who received CRT-P/CRT-D experienced significant reductions in QRS duration (160±21 vs. 141±24 ms, p<0.001) as well as improvement in New York Heart Association functional class.
The Síncrone study shows that the use of implantable devices in HF with reduced LVEF in Portugal is in accordance with international recommendations and that patients presented functional improvement and reduced one-year mortality.
本研究旨在记录葡萄牙在心力衰竭（HF）和左心室射血分数降低（LVEF）患者中使用电子心脏设备的临床实践情况。
Síncrone研究是一项前瞻性观察性多中心注册研究，于2006年至2014年在葡萄牙的16个中心开展。根据研究开始时欧洲心脏病学会的建议，纳入诊断为HF、LVEF<35%且有植入式心脏复律除颤器（ICD）和/或心脏再同步治疗（CRT）设备植入指征的成年患者。各中心按自身实践对患者进行为期一年的随访。
注册研究共纳入486例患者，其中一半接受ICD治疗，另一半接受CRT起搏器（CRT-P）或CRT除颤器（CRT-D）治疗。平均年龄为65±12岁，HF最常见的病因是缺血性（47%）和特发性扩张型心肌病（28%）。一年时的总死亡率为3.6%，住院率为11%，接受CRT-P/CRT-D治疗的患者住院率显著高于接受ICD治疗的患者（17%对5.6%，p<0.001）。接受CRT-P/CRT-D治疗的患者QRS时限显著缩短（160±21对141±24毫秒，p<0.001），纽约心脏协会功能分级也有所改善。
Síncrone研究表明，葡萄牙在LVEF降低的HF患者中使用植入式设备符合国际建议，且患者功能得到改善，一年死亡率降低。
