左室同步化参数的时间变化及心脏再同步化治疗的结果

IF 0.3 Q4 CRITICAL CARE MEDICINE

Egyptian Journal of Critical Care Medicine Pub Date : 2016-08-01 DOI:10.1016/j.ejccm.2016.04.001

Walid Ahmed , Wael Samy , Osama Tayeh , Noha Behairy , Alia Abd el Fattah

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引用次数: 0

摘要

背景左心室非同步化在预测心脏再同步化治疗(CRT)的反应中起着重要作用。方法30例患者行CRT植入术。通过门控SPECT左室相分析评估左室非同步化。结果30例患者接受CRT治疗，平均年龄58.7±9.0岁，男性24例。CRT植入对心功能预后良好(植入前LVEF: 26.8±4.7% vs植入后29.1±6.4%;p = 0.002)。19名患者记录了逆行左室重塑(小于15%)。左室非同步化参数的时间变化与左室反向重构相关。应用ROC曲线进行LV期分析，直方图带宽截断值为152°时，预测CRT无反应状态的敏感性为72.7%，特异性为63.2%。直方图标准差截断值为54°时，敏感性为81.8%，特异性为63.2%。结论CRT应答者的左室不同步特征有所改善。门控SPECT LV分析可作为CRT无反应的预测指标。左室反向重构与左室非同步化参数的时间改善有关。

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Temporal changes of left ventricular synchronization parameters and outcomes of cardiac resynchronization therapy

Background

Left ventricular dyssynchrony plays an important role in predicting response to cardiac resynchronization therapy (CRT).

Methods

Thirty patients underwent CRT implantation. Assessment of left ventricular (LV) dyssynchrony was done through Gated SPECT LV phase analysis.

Results

Thirty patients received CRT (mean age 58.7 ± 9.0, 24 males). CRT implantation had a favorable prognosis on cardiac functions (LVEF preimplantation: 26.8 ± 4.7% versus 29.1 ± 6.4% post-implantation; P = 0.002). Reverse LV remodeling (⩾15%) was documented in 19 patients. Temporal changes in LV dyssynchrony parameters were correlated to LV reverse remodeling. Applying ROC curve for LV phase analysis showed that a cutoff value of 152° for histogram bandwidth had a sensitivity of 72.7% and specificity of 63.2% for predicting CRT non-response status. Also, a cutoff value of 54° for histogram standard deviation had a sensitivity of 81.8% and specificity of 63.2%.

Conclusion

Responders of CRT showed improved LV dyssynchrony profiles. Utilizing Gated SPECT LV analysis could provide predictors for CRT non-response. Reverse LV remodeling is associated with temporal improvements in LV dyssynchrony parameters.

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来源期刊

Egyptian Journal of Critical Care Medicine

自引率

0.00%

发文量

审稿时长

42 weeks

期刊介绍： The Egyptian Journal of Critical Care Medicine is the official Journal of the Egyptian College of Critical Care Physicians, the most authoritative organization of Egyptian physicians involved in the multi-professional field of critical care medicine. The journal is intended to provide a peer-reviewed source for multidisciplinary coverage of general acute and intensive care medicine and its various subcategories including cardiac, pulmonary, neuro, renal as well as post-operative care. The journal is proud to have an international multi-professional editorial board in the broad field of critical care that will assist in publishing promising research and breakthrough reports that lead to better patients care in life threatening conditions, and bring the reader a quick access to the latest diagnostic and therapeutic approaches in monitoring and management of critically ill patients.