Dikdan Sean J, Co Michael Lawrenz, Pavri Behzad B
Thomas Jefferson University Hospital, Philadelphia, PA, 19107, USA.
Curr Cardiol Rep. 2022 Dec;24(12):1957-1972. doi: 10.1007/s11886-022-01797-z. Epub 2022 Nov 29.
Dyssynchrony occurs when portions of the cardiac chambers contract in an uncoordinated fashion. Ventricular dyssynchrony primarily impacts the left ventricle and may result in heart failure. This entity is recognized as a major contributor to the development and progression of heart failure. A hallmark of dyssynchronous heart failure (HF) is left ventricular recovery after dyssynchrony is corrected. This review discusses the current understanding of pathophysiology of HF and provides clinical examples and current techniques for treatment.
Data show that HF responds poorly to medical therapy. Cardiac resynchronization therapy (CRT) in the form of conventional biventricular pacing (BVP) is of proven benefit in HF, but is limited by a significant non-responder rate. Recently, conduction system pacing (His bundle or left bundle branch area pacing) has also shown promise in correcting HF. HF should be recognized as a distinct etiology of heart failure; HF responds best to CRT.
当心脏腔室的各部分以不协调的方式收缩时，就会出现不同步。心室不同步主要影响左心室，并可能导致心力衰竭。这种情况被认为是心力衰竭发生和进展的主要因素。不同步性心力衰竭（HF）的一个标志是在不同步得到纠正后左心室恢复。本综述讨论了目前对HF病理生理学的理解，并提供了临床实例和当前的治疗技术。
数据表明，HF对药物治疗反应不佳。传统双心室起搏（BVP）形式的心脏再同步治疗（CRT）已被证明对HF有益，但受到显著的无反应率的限制。最近，传导系统起搏（希氏束或左束支区域起搏）在纠正HF方面也显示出前景。HF应被视为心力衰竭的一种独特病因；HF对CRT反应最佳。
