真性及非真性左束支传导阻滞心力衰竭患者心脏再同步治疗预后分析

发布时间：2018-12-11 15:59

【摘要】：目的回顾性分析真性左束支传导阻滞、非真性左束支传导阻滞的慢性心力衰竭患者接受心脏再同步化治疗(CRT)的预后情况。方法选取2005年12月至2015年12月于中国医科大学附属第一医院成功植入CRT-P/D的慢性心力衰竭患者47例。根据术前体表心电图表现分为真性左束支传导阻滞组(t-LBBB,25例),非真性左束支传导阻滞组(nt-LBBB,22例),分析比较各组患者预后情况。结果t-LBBB组左室射血分数较nt-LBBB组增加[△LVEF:t-LBBB对nt-LBBB(17.12±6.80)%对(11.29±9.91)%,P=0.039];t-LBBB组左室舒末内径及左室收缩末容积较nt-LBBB组显著改善[△LVEDD:t-LBBB对nt-LBBB:(-9.88±6.55)mm对(-5.77±6.57)mm,P=0.041;△LVESV:t-LBBB对nt-LBBB:(-54.56±37.14)mL对(-25.59±46.81)mL,P=0.025]。多变量回归分析示真性左束支传导阻滞是CRT术后有反应的独立预测因子。结论QRS波形符合真性左束支传导阻滞标准的患者更能从CRT治疗中获益。
[Abstract]:Objective to retrospectively analyze the prognosis of patients with chronic heart failure (CHF) receiving cardiac resynchronization therapy (CRT) in patients with true left bundle branch block and non true left bundle branch block. Methods from December 2005 to December 2015, 47 patients with chronic heart failure were successfully implanted with CRT-P/D in the first affiliated Hospital of China Medical University. According to the electrocardiogram (ECG), the patients were divided into two groups: genuine left bundle branch block group (t-LBBB block group, n = 25) and non-true left bundle branch block group (nt-LBBB,22 group, n = 25). The prognosis of each group was analyzed and compared. Results left ventricular ejection fraction (LVEF) in t-LBBB group was significantly higher than that in nt-LBBB group [LVEF:t-LBBB vs nt-LBBB (17.12 卤6.80)% vs (11.29 卤9.91)%, P < 0.039]. Left ventricular end-diastolic diameter and left ventricular end-systolic volume in t-LBBB group were significantly improved compared with nt-LBBB group [LVEDD:t-LBBB vs nt-LBBB: (-9.88 卤6.55) mm vs (-5.77 卤6.57) mm,P=0.041;] LVESV:t-LBBB vs nt-LBBB: (-54.56 卤37.14) mL vs (-25.59 卤46.81) mL,P=0.025]. Multivariate regression analysis showed that true left bundle branch block was an independent predictor of response after CRT. Conclusion patients with true left bundle branch block who have QRS waveform can benefit more from CRT treatment.
【作者单位】：中国医科大学附属第一医院心内科;
【基金】：辽宁省科技公关课题(201225084)
【分类号】：R541.6

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