巨大室间隔矛盾位移度预测终末期心衰患者再同步化治疗无应答的发生[权威资料].docVIP

巨大室间隔矛盾位移度预测终末期心衰患者再同步化治疗无应答的发生 　　【摘要】 目的：判定巨大室间隔矛盾位移度对于终末期心衰患者再同步化治疗（CRT）无应答的预测价值。方法：回顾性分析在本院行CRT治疗的19例患者的临床资料，随访患者CRT术前、术后及1年期随访室间隔位移度、LVEF、RVEF等心脏彩超指标变化，同时观测患者心血管死亡率、6个月再住院率、CRT无应答率的相关关系。结果：19例患者入选，在随访过程中，其中10例CRT应答，9例CRT无应答。多变量回归性分析室间隔矛盾位移度为终末期心衰患者无应答的独立预测因子。在CRT应答与无应答分组的比较中，RVEF、LVEF及肺动脉高压CRT治疗前后比较差异均有统计学意义（P0.05）。再以室间隔为分组的比较中，巨大室间隔位移组6个月在住院率、CRT应答率、心血管死亡率均明显高于对照组，差异均有统计学意义（P0.05）。结论：巨大室间隔矛盾位移度与终末期心衰患者CRT无应答密切相关，它将是CRT无应答的强烈预测因子。 　　【关键词】 心脏再同步化治疗； 心衰； 巨大室间隔矛盾运动位移度 　　【Abstract】 Objecive：To identify if huge interventricular septum contradiction shift could be a new criteria of predicting no-response to cardiac resynchronization therapy（CRT） in the end-stage of heart failure.Method：We retrospectively reviewed 19 patients received a CRT device in our hospital and analyzed different contradiction shift distance relating to the response of CRT.Besides，some echocardiography index including LVEF，RVEF，etc were evaluated pre-CRT，post-CRT and during the follow up.The cardiovascular mortality，six monthes rehospitalization rate and CRT response rate were also confirmed at the same time.Result：Nineteen patients enrolled，ten of them responsed to CRT while nine of them showed no response to CRT.Multivariate analysis showed that interventricular septum contradiction shift distance was independent predictors of no-response to CRT in the end-stage heart failure patients.There was statistical difference in the cardiovascular mortality（P0.05），six month rehospitalization rate and CRT response rate between the groups termed by huge interventricular septum contradiction shift.Conclusion：Interventricular septum contradiction shift distance is highly related to the response to CRT in the patients suffering from terminal stage of heart failure.It will be a new predictor to CRT response. 　　【Key words】 Cardiac resynchronization therapy； Heart failure； Huge interventricular septum contradiction shift distance 　　First-author’s address：The Central Hospital of Liaoyan