心脏再同步化治疗对充血性心力衰竭患者内皮功能的影响

Effect of cardiac resynchronization therapy on vascular endothelial function in patients with congestive heart failure

目的:探讨心脏再同步化治疗(CRT)对充血性心力衰竭(心衰)患者内皮功能的影响。方法:扩张型心肌病并发心衰患者分为药物治疗组(10例)和CRT+药物治疗组(12例),分别在治疗前、治疗12周末,检测心脏超声、血管内皮功能、脑钠肽(BNP)。结果:与药物治疗组比较,CRT+药物治疗组明显增加患者的心脏输出量[(4.32±1.50)L/min∶(3.41±1.00)L/min,P<0.05]及肱动脉内径的变化率(FMD)[(1 718±123)%∶(976±118)%,P<0.05],FMD和心输出量呈正相关(r=0.6,P=0.003)。结论:CRT可以提高内皮细胞的功能,其机制可能是通过增加心输出量来实现的。

To explore the effect of cardiac resynchronization therapy （CRT） on vascular endothelial function in patients with congestive heart failure （CHF）. Method：CHF patients with dilated cardiomyopathy were divided into optimal drug group （n = 10） and CRT＋drug group （n = 12）. Echocardiographic parameters, flow mediated diameter （FMD）, brain natriuretic peptide （BNP） were evaluated before therapy and 12 weeks after therapy started. Result： Compared with drug group, cardiac output （E4.32 ± 1.50] L/min ： [3.41 ± 1.00] L/min, P〈0.05） and FMD （[1718±123]% ： [976±118]%, P〈0.05） were increased significantly in CRT＋drug group. There was a positive correlation between FMD and cardiac output （r=0.6, P=0. 003）. Conclusion： CRT could improve endothelial function by increasing cardiac output.