CT冠状静脉成像与室壁运动评价用于心脏再同步化治疗

CT coronary vein imaging and assessment of ventricular wall motion in cardiac resynchronization therapy

心脏再同步化治疗(CRT)在心力衰竭合并心室电-机械失同步的治疗中取得了令人满意的成就,但部分患者对CRT低反应或无反应。将左心室起搏电极置于心室最延迟收缩区域的冠状静脉属支内,并避开瘢痕负荷过重区域,提高CRT应答率,最大限度提高临床获益。CRT术前较全面获取冠状静脉解剖及延迟收缩的心肌节段等信息,对确定左心室起搏电极植入部位有重要意义。本文针对CT冠状静脉成像及室壁运动评价用于CRT的进展进行综述。

Cardiac resynchronization therapy(CRT)has achieved satisfactory achievements in the treatment of heart failure patients with ventricular electro-mechanical dyssynchrony.However,there are still some patients with low or no response to CRT.The left ventricular pacing electrode placed in the coronary vein branch in the most delayed region of myocardial contraction and avoided the region of scar overload may improve the response rate of CRT,therefore maximize the clinical benefits of CRT.Comprehensive information such as coronary vein anatomy and delayed contractile myocardial segment before CRT operation are of great significance for determining the implantation site of the left ventricular pacing electrode.The research progresses and clinical applications of CT in coronary vein system imaging and evaluation on ventricular wall motion were reviewed in this article.