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目的:观察一键优化心脏再同步化治疗(cardiac resynchronization therapy,CRT)慢性心力衰竭的中远期疗效。方法:14例心力衰竭患者接受CRT治疗,分别于置入前、置入术后3、6、12个月行一键优化治疗,同时行超声心动图(观察心腔结构、二尖瓣反流、主动脉射血速度时间积分)、心电图、脑钠素(BNP)检查等,评价CRT临床疗效。结果:一键优化最佳优化AV间期120～180(158.33±19.46)ms之间和VV间期4～28(15.83±7.12)ms之间,临床症状改善,6min步行距离由(254.03±26.98)增加至(346.82±31.59)m,QRS时限由(134.64±16.48)ms降至(110.00±11.68)ms,P=0.001,P<0.05。置入后左室舒张末内径较置入前明显缩小[(73.86±9.85)mm对(60.93±9.07)mm,P<0.05];左室射血分数提高[(0.29±0.04)对(0.52±0.09),P<0.01];VTI(主动脉前向血流速度时间积分)由(16.41±3.71)增加至(21.83±4.80),P<0.05;血浆BNP值由置入前(925.89±404.54)ng/L降至(77.57±16.52)ng/L,P<0.05。结论:一键优化可以提高CRT对慢性心力衰竭患者中远期疗效。
Objective: To observe the long-term effect of one-key optimization of cardiac resynchronization therapy (CRT) in patients with chronic heart failure. Methods: Fourteen patients with heart failure were treated with CRT. One-key optimal therapy was performed at 3, 6, and 12 months after implantation. Echocardiography was performed at the same time (heart structure, mitral regurgitation , Aortic ejection velocity time integral), electrocardiogram, brain natriuretic peptide (BNP) examination, evaluation of CRT clinical efficacy. Results: One-touch optimal optimal AV interval was between 120 ~ 180 (158.33 ± 19.46) ms and VV interval between 4 ~ 28 (15.83 ± 7.12) ms. Clinical symptoms improved and the distance of 6min walk was (254.03 ± 26.98 ) Increased to (346.82 ± 31.59) m, QRS duration decreased from (134.64 ± 16.48) ms to (110.00 ± 11.68) ms, P = 0.001, P <0.05. The left ventricular end-diastolic diameter was significantly reduced compared with that before implantation [(73.86 ± 9.85) mm vs (60.93 ± 9.07) mm, P <0.05]; left ventricular ejection fraction increased [(0.29 ± 0.04) vs. (P <0.01), P <0.01]; VTI increased from (16.41 ± 3.71) to (21.83 ± 4.80), P <0.05; plasma BNP increased from (925.89 ± 404.54) ng / L to (77.57 ± 16.52) ng / L, P <0.05. Conclusion: One-click optimization can improve long-term efficacy of CRT in patients with chronic heart failure.