Clinical efficacy and predictor of cardiac resynchronization therapy on left bundle branch block-associated heart dysfunction-中国期刊网

摘要 BackgroundLeftbundlebranchblock(LBBB)resultsinanalteredpatternofleftventricular(LV)activationandsubsequentcontraction.CardiacsynchronyandcardiacfunctionaredeterioratedbyLBBB.However,theeffectofLBBBhistoryonprogressiveheartdysfunctionandclinicalefficacyofcardiacresynchronizationtherapy(CRT)insuchpatientsarenotclear.InthisstudyweexploretheclinicalefficacyandpredictorofcardiacresynchronizationtherapyinLBBBheartdysfunction.MethodsTwenty-sevenLBBBpatientswithsevereheartfailureweretreatedwithCRT.Twenty-sixLBBBpatientswithoutCRTservedascontrol.During6monthsfollow-up,ECG,plasmaNT-proBNPandechocardiogramindexesweremeasured.ResultsComparedwithbaseline,NYHAfunctionalclassof23patients(85.2%)wasimprovedinCRTgroup.Comparedwithbaselineandcontrol,QRSduration(QRSd)wassignificantlymorenarrow(P=0.023,P=0.019),NT-proBNPwassignificantlylower(P=0.011,P=0.009),ventricularseptaltoleftventricularposteriorwalldelaytimeandleftventriculardyssynchronyindex(Ts-SD)weresignificantlyworse(P<0.05);leftventricularejectionfraction,leftventricularend-systolicvolume,mitralregurgitationareaweresignificantlyimprovedinCRTgroup(P<0.05).whentheLBBBhistorywas≥2yearsandQRSd≥155ms,thesensitivityandspecificityofCRTsuper-responsewere53.4%and85.6%respectively.ConclusionsCRTcanimprovethesynchronizationandhemodynamicofLBBBpatientswithheartdysfunction,theLBBBhistory≥2yearsandQRSd≥155msareoneoftheCRTsuper-responsepredictors.

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Clinical efficacy and predictor of cardiac resynchronization therapy on left bundle branch block-associated heart dysfunction

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Clinical efficacy and predictor of cardiac resynchronization therapy on left bundle branch block-associated heart dysfunction

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