慢性心力衰竭患者CRT治疗前后心功能及超敏C反应蛋白变化

目的观察慢性心力衰竭（简称心衰）患者行心脏再同步化治疗前后心功能及超敏C反应蛋白变化。方法对本院18例符合CRT植入指征的慢性心力衰竭患者行心脏再同步化治疗，1例永久性房颤患者同时行房室结消融术，并于术后24h、3个月、6个月行AV、VV优化，观察术前、术后3个月、6个月NYHA心功能分级、左室射血分数（LVEF）、左室舒张末内径（LVEDD）、二尖瓣反流量（MRA）、心脏同步化指标-主肺动脉射血期前时间差（IVMD）、室间隔及左室后壁收缩达峰时间延迟（SPWMD）及Hs—CRP变化。结果18例患者植入后心衰症状明显改善，LVEF、LVEDD、MRA等心功能指标明显改善，Hs—CRP较术前明显下降。结论慢性心衰患者行再同步化治疗后，通过心超优化AV、VV间期后，心功能明显改善、Hs—CRP水平较术前下降。

Objective To investigate variations of heart function and the levels of hypersensitive C reactive protein before and after CRT treatment in patients with chronic heart failure. Methods 18 heart failure patients who reeeved CRT,AVJ were ablated by radiofrequency in one patient with permanent atrial fibrillation. The AV ,VV delay were optimized by echocardiography at 24 hour, 3 months,6 months after operation. The NYHA functional class, left ventricular ejection fraction, Left ventricular end -diastolic dimension, Mitral regurgition area, The synchrony index and the levels of hypersensitive C - reactive protein were measured before procedure and 3 months, 6 months after implantation. Results Compared with pro - CRT, The NYHA functional class, left ventricular ejection fraction and the synchrony index improved, Left ventrieular end - diastolic dimension, Mitral regurgition area decerased, the plasma concentration of hypersensitive C - reactive protein significantly decreased too. Conclusion CRT can improved cardiac function and make the levels of Hs - CRP decrease after AV, VV delay optimization guided by echoeardiography.