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目的:观察窄QRS波慢性心力衰竭(CHF)患者的双心室再同步治疗的临床疗效。方法:筛选16例窄QRS波CHF患者行双心室再同步治疗,所有病例均经冠状静脉窦植入左心室导线至心脏静脉,术后平均随访1～43个月,平均13个月,观察心功能、左心室射血分数、二尖瓣反流面积、左心室舒张末和收缩末内径等的变化。结果:16例患者治疗后心功能明显改善,有效率75%,心功能从Ⅲ～Ⅳ级(NYHA分级)改善为Ⅱ～Ⅲ级,左心室射血分数从(0.31±0.11)%提高至(0.38±0.10)%,P<0.05,每搏输出量从(74±8)ml提高至(96±4)ml,P<0.05,二尖瓣反流面积从(8±4)cm2减少至(6±3)cm2,P<0.05,左心室舒张末内径、收缩末内径虽有缩小趋势但没有显著差异[(69±7)mmvs.(68±9)mm;(59±10)mmvs.(56±11)mm]。结论:双心室再同步治疗对某些窄QRS波CHF患者同样有效。
Objective: To observe the clinical effect of biventricular resynchronization therapy in patients with narrow QRS wave chronic heart failure (CHF). Methods: Sixteen patients with narrow QRS wave CHF were selected for biventricular resynchronization therapy. All patients underwent coronary venous sinus implantation of left ventricular leads to the heart vein. The average follow-up was 1 to 43 months (average 13 months) Function, left ventricular ejection fraction, mitral regurgitation area, left ventricular end diastolic and end-systolic diameter and other changes. Results: After treatment, the cardiac function of 16 patients was improved obviously, the effective rate was 75%, the cardiac function improved from grade Ⅲ ~ Ⅳ (NYHA grade) to grade Ⅱ ~ Ⅲ, and the left ventricular ejection fraction increased from (0.31 ± 0.11)% to (P <0.05), mitral regurgitation area decreased from (8 ± 4) cm2 to (96 ± 4) ml and (69 ± 7) mmvs. (68 ± 9) mm; (59 ± 10) mmvs. (6 ± 3) cm 2, P <0.05. There was no significant difference between left ventricular end-diastolic diameter and end- 56 ± 11) mm]. Conclusions: Biventricular resynchronization therapy is equally effective for some patients with narrow QRS wave CHF.