多巴酚丁胺负荷超声心动图在心脏再同步化治疗过程中的研究进展

Progress in the use of dobutamine echocardiography in cardiac resynchronization therapy

心力衰竭（简称心衰）是具有较高患病率和病死率的严重疾患,虽然近年来药物治疗取得了长足进展,但仍有相当数量患者疗效不佳。心脏再同步化治疗（CRT）是指通过植入右心室及左心室电极,同时起搏左、右心室,通过多部位起搏恢复左、右心室同步收缩。临床研究证实的CRT对心力衰竭患者的各种改善均见于对CRT有反应的患者,但有20%~30%的患者对CRT无反应。近期研究主要集中在扩大CRT适应证,强调轻微或无症状患者亦可从CRT中获益。心肌负荷超声等超声新技术可更好地评估心肌运动的不同步,综合分析各种超声指标可提高对CRT反应的预测价值,有效减少不能从CRT中获益的患者。本文就多巴酚丁胺负荷超声心动图在CRT治疗过程中的研究应用进展作一综述。

Heart failure（HF） is a serious disease with high morbidity. Although in recent years great progress has been made in drug treatment, there are still quite a number of patients with poor efficacy. Cardiac resynchronization therapy（CRT） by planting electrode both in right ventricular and left ventricular, pacing left and right ventricular at the same time, restoring of left ventricular synchronous contraction. CRT reduces symptoms and improves left ventricular function in many patients with HF due to left ventricular systolic dysfunction and dyssynchrony, however, about 20% to 30% of patients do not respond to CRT. Recently studies have focused on expanding the CRT indication, emphasizing that patients with mild or no symptoms may also can be referred to CRT. Dobutamine echocardiography can better assess asynchronous. Comprehensive analysis of various index of echocardiography can improve the predictive value of response to CRT, reducing the number of patients who can not benefit from CRT effectively. this article review the application progress of dobutamine echocardiography in CRT.