慢性充血性心力衰竭心脏再同步化治疗研究进展

Advances in Research of Cardiac Resynchronization Therapy for Congestive Heart Failure

心电学异常往往合并心衰共存于心肌病患者中 ,异常的心电顺序使心脏收缩和舒张不协调 ,从而损害心功能。近来短期和长期研究发现应用心脏起搏可使心脏活动再同步、改善心功能、提高生活质量和生存率 ,认为心脏再同步化疗法是严重心衰合并心电学异常患者的一种理想的非药物辅助治疗选择。其潜在的机制包括 :心脏整体活动的再同步化 ,拮抗神经内分泌活性、逆转心脏重塑 ,抗心律失常等。该方法有严格的适应证 ,可根据患者情况选择不同的方法。文章综述了心脏失同步化的病理生理及心脏再同步化治疗相关临床试验、显效机制。

Cardiomyopathy often is a combination of heart fai lu re and disorder cardiac electrophysiology.Abnormal activation sequence could lea d to heart systolic and diastolic asynchrony,impair heart function.A serial of s hort and long term clinical trials had been suggested that cardiac resynchroniza tion therapy(CRT) is an ideal non-pharmacological supplementary therapy strateg y in patients with severe heart failure and disorder electrophysiology.The poten tial CRT mechanisms consist of cardiac integral contraction resynchronization,re duction sympathetic nerve activation,reverse ventricular remodeling and anti-ar rhythmia,et al.CRT has strict indication,but also,been selected different method s by means of patients' condition.This article reviews that pathophysiology of c ardiac dyssynchrony and CRT clinical trials,mechanisms,technique,unsolved issue.