主动脉根部收缩期运动可预测心脏再同步治疗的反应。
Systolic aortic root motion predicts response to cardiac resynchronization therapy.
作者信息
Celikyurt Umut, Acar Burak, Hidayet Siho, Karauzum İrem, Karauzum Kurtulus, Vural Ahmet, Agacdiken Aysen
机构信息
Department of Cardiology, Kocaeli University Medical Faculty, Kocaeli, Turkey.
Department of Cardiology, İnönü University Medical Faculty, Malatya, Turkey.
出版信息
Pacing Clin Electrophysiol. 2019 Nov;42(11):1471-1476. doi: 10.1111/pace.13792. Epub 2019 Sep 3.
BACKGROUND
Cardiac resynchronization therapy (CRT) is recommended for patients with advanced chronic heart failure. Systolic aortic root motion (SARM) has been investigated in dilated cardiomyopathy patients and found that heart failure patients had reduced SARM. We aimed to investigate the relationship between SARM and response to CRT.
METHODS
Fifty-six patients with advanced heart failure, wide QRS complex, and LVEF ≤35% were included. Transthoracic echocardiography was performed before, and repeated at 6 months in follow-up. Systolic aortic root motion was measured in each patient before the device implantation. Echocardiographic response to CRT was defined by a ≥15% reduction in left ventricular end-systolic volume at 6 months follow-up.
RESULTS
Forty patients (71%) had CRT response after 6 months of follow-up. In multivariate analysis, significant associates of response to CRT was evaluated adjusting for functional capacity, etiology of cardiomyopathy, QRS duration, baseline left ventricular dimensions/volumes and SARM. SARM was the only predictor of response to CRT (OR 1.818, 95% CI, 1.101-3.003, P = .019).
CONCLUSIONS
SARM predicts non-response to CRT and may help in the selection of CRT candidates.
背景
心脏再同步治疗（CRT）适用于晚期慢性心力衰竭患者。已对扩张型心肌病患者的收缩期主动脉根部运动（SARM）进行了研究，发现心力衰竭患者的SARM降低。我们旨在研究SARM与CRT反应之间的关系。
方法
纳入56例晚期心力衰竭、QRS波增宽且左心室射血分数（LVEF）≤35%的患者。在植入装置前及随访6个月时重复进行经胸超声心动图检查。在每个患者植入装置前测量收缩期主动脉根部运动。CRT的超声心动图反应定义为随访6个月时左心室收缩末期容积减少≥15%。
结果
随访6个月后，40例患者（71%）出现CRT反应。在多变量分析中，对功能能力、心肌病病因、QRS时限、基线左心室尺寸/容积和SARM进行校正后，评估CRT反应的显著相关因素。SARM是CRT反应的唯一预测因素（比值比1.818，95%可信区间，1.101 - 3.003，P = 0.019）。
结论
SARM可预测CRT无反应，并可能有助于CRT候选者的选择。
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