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目的:观察心脏再同步化治疗(CRT)晚期充血性心力衰竭的临床疗效。方法:晚期扩张型心肌病患者13例接受CRT,NYHA心功能分级为Ⅲ～Ⅳ级,左室射血分数(LVEF)为(27.4±9.7)%,左室舒张末期内径(LVEDD)为(72.8±9.6)mm,QRS时限为(137.8+30.4)ms。术后观察QRS时限的变化,随访左室电极起博阈值、心功能分级、LVEF及LVEDD。结果:术后QRS时限减少为(123.8±17.1)ms。所有患者随访3～38月,左室电极慢性阈值为(1.1±0.6)V/0.4 ms。与术前相比,NYHA心功能分级从(3.4±0.5)降低为(1.5±0.9);LVEF从(27.4±9.7)%上升至(43.5±18.5)%(P<0.05);LVEDD从(72.8±9.6)mm缩小为(65.5±11.6)mm(P<0.05)。结论:CRT可改善心功能,提高LVEF,并可逆转左心室重构。
Objective: To observe the clinical effect of cardiac resynchronization therapy (CRT) in patients with advanced congestive heart failure. Methods: Thirteen patients with advanced dilated cardiomyopathy received CRT and NYHA functional class Ⅲ ~ Ⅳ, left ventricular ejection fraction (LVEF) was (27.4 ± 9.7)%, left ventricular end diastolic diameter (LVEDD) was (72.8 ± 9.6) mm, QRS duration was (137.8 + 30.4) ms. The changes of QRS duration were observed and the left ventricular electrode pacing threshold, cardiac function classification, LVEF and LVEDD were followed up. Results: The postoperative QRS duration decreased to (123.8 ± 17.1) ms. All patients were followed up for 3 ~ 38 months, the chronic threshold of left ventricular electrode was (1.1 ± 0.6) V / 0.4 ms. Compared with preoperative, NYHA functional class decreased from (3.4 ± 0.5) to (1.5 ± 0.9); LVEF increased from (27.4 ± 9.7)% to (43.5 ± 18.5)% ± 9.6) mm to (65.5 ± 11.6) mm (P <0.05). Conclusion: CRT can improve cardiac function, increase LVEF and reverse left ventricular remodeling.