组织多普勒超声评价窄QRS间期患者心脏再同步治疗效果

Efficacy research of cardiac resynchronization therapy in heart failure with narrow QRS complexes

目的组织多普勒超声（TDI）指导下评价窄QRS间期合并心室不同步患者行心脏再同步治疗（CRT）对临床预后的影响。方法91例经超声心动图和TD[确诊为心脏收缩不同步的慢件心力衰竭患者，按是否接受CRT分为CRT组（窄QRS间期21例，宽QRS间期22例）和对照组（宽QRS间期25例，窄QRS间期23例）。对所有患者进行1年的随访，评价心功能及生存率。结果CRT组6min步行试验、生活质量积分、心功能（NYHA分级）明显改善。超声心动图及TDI结果显示，CRT组左心室收缩未容积、左心室舒张末容积明显减少，射血分数明显增加。与各对照组亚组相比，CRT组中窄QRS亚组心功能改善，6min步行试验距离、左心室射血分数、生活质量积分明垃增加，左心室收缩末容积和左心窀舒张末容积明显减少。结论在TDI指导下，窄QRS间期慢性心力衰竭可以从CRT中获益。

Objective To evaluate the effects of cardiac resynchronization therapy （CRT） in congestive heart failure （CHF） patients presenting with left ventricular mechanical asynchrony and analyze wether CHF patients with narrow QRS complexes benefit from CRT. Methods We enrolled 91 patients who had an indication for CRT with conventional echoeardiographic technique and tissue doppler imaging （TDI）. Patients were assigned to the CRT group（narrow QRS group 21 patients,wide QRS group 22 patients） and to a control group （narrow QRS group 23 patients ,wide QRS group ：25 patients）. We evaluated cardiac function,and survival rates at one year follow-up. Results In the CRT group at one year,there was a significant improvement over con- trols on 6-min walking test,quality-of-life score,and NYHA functional class,as well as a significant reduction in left ventricular （LV） end-systolic volume and LV end-diastolic volume. Further analysis showed similar improvement in CRT- narrow QRS complexes subgroup. Conclusion CRT can improve heart function and increase quality of life in patients with moderate-to-severe CHF, narrow QRS complexes CHF patients also benefit from CRT.