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Cardiac Resynchronization Therapy in the Cardiorenal Syndrome英文文献资料.doc

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Cardiac Resynchronization Therapy in the Cardiorenal Syndrome英文文献资料

SAGE-HindawiAccesstoResearch InternationalJournalofNephrology Volume2011,ArticleID168461,6pages doi:10.4061/2011/168461 ReviewArticle CardiacResynchronizationTherapyin theCardiorenalSyndrome MargotK.DavisandSeanA.Virani DivisionofCardiology,GordonandLeslieDiamondHealthCareCentre,TheUniversityofBritishColumbia, Vancouver,BC,CanadaV5Z1M9 CorrespondenceshouldbeaddressedtoMargotK.Davis,margot.k.davis@ Received14September2010;Accepted21March2011 AcademicEditor:AnjayRastogi Copyright?2011M.K.DavisandS.A.Virani.ThisisanopenaccessarticledistributedundertheCreativeCommonsAttribution License,whichpermitsunrestricteduse,distribution,andreproductioninanymedium,providedtheoriginalworkisproperly cited. Thecardiorenalsyndrome(CRS)isacomplexclinicalsyndromeinwhichdysfunctionofeithertheheartorthekidneysa?ects thefunctioningoftheotherorgansystem.Manytherapiesusedinheartfailurehavefurtherdetrimentale?ectsonrenalfunction. Cardiacresynchronization therapy (CRT) isa relatively new formofdevice therapy thatreduces morbidityand mortality in patientswith heart failure. Thisreview will discussthee?ects ofCRT onrenal function inpatientswith CRS, theimpactof baselinerenalfunctiononresponsetoCRT,andpotentialrisksassociatedwithCRTinthisuniquepopulation. 1.Introduction Asourunderstandingoftheunderlyingmechanismsof CRS has progressed, so has our recognition of the mag- nitude of the problem and of its prognostic signi?cance. In ADHERE, a national registry of more than 100 000 nonselectedpatientsadmittedtohospitalwithacutedecom- pensated heart failure, 31% of patients had chronic renal insu?ciency,20%hadserumcreatinine levels2.0mg/dL, and 5% were receiving dialysis [4]. Furthermore, even moderate renal insu?ciency is associated with increased mortality in patients with symptomatic or asymptomatic LV dysfunction [5] or heart failure with preserved systolic function [6]; creatinine clearance predicts mortality inde- pendent of ejection fraction or functional capacity [7]. In theStudiesofLeftVent