缺血性与非缺血性心肌病的除颤器心脏再同步化疗法

IF 1.2 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Goekhan Yuecel, Leo Gaasch, Svetlana Hetjens, Oezge-Nur Oeztuerk, Gamze Yildirim, Stefan Pfleger, Daniel Duerschmied, Ibrahim Akin, Juergen Kuschyk
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引用次数: 0

摘要

植入式心律转复除颤器(CRT-D)的心脏再同步化治疗是心力衰竭(HF)患者的既定治疗方案。Mannheim CArdiac Resynchronization TherApy RetrospeCtive ObservAtioNAl (MARACANA) Registry(曼海姆心脏再同步治疗回顾性观察)回顾性纳入了 2013 年至 2021 年在本中心接受 CRT-D 治疗的所有患者。CRT-D 接受者(n = 380)被分为缺血性心肌病(ICM,n = 206)和非缺血性心肌病(NICM,n = 174)两组。两组患者的生存率、左心室射血分数(LVEF)、HF 住院率、固有和起搏 QRS 宽度、NYHA 分级以及 HF 长期(59.ICM 患者年龄较大(73.3 ± 8.4 岁对 67.7 ± 10.8 岁),以男性为主(86.4% 对 74.7%),基线时肌酐值较高(1.57 ± 0.92 对 1.31 ± 0.66 mg/dL,P<0.05)。NICM 患者的平均生存期更长(51.9 ± 1.2 个月对 54.4 ± 1.1 个月,P = 0.03)。5 年后,两组患者的 NYHA(2.93 ± 0.4 对 2.79 ± 0.5-2.19 ± 0.7 对 1.79 ± 0.7)和 LVEF(26.4 ± 6.8 对 27% ± 6.9% 到 35.7 ± 9.6 对 44 ± 11%,P 均<0.05)改善情况相似。ICM患者第一年内因心房颤动住院的次数较多(几率比1.9,P<0.05),而NICM患者的电重塑更为显著(5年后QRS宽度为157.1±19.4毫秒,而固有QRS宽度为116.6±12.7毫秒,起搏QRS宽度为131.9±21毫秒,P均<0.05)。心房颤动某些方面的改变可能受到时间和病因相关合并症的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cardiac Resynchronization Therapy with Defibrillator in Ischemic Versus Nonischemic Cardiomyopathy.

Cardiac resynchronization therapy with implantable cardioverter defibrillators (CRT-Ds) are established therapy options for patients suffering from heart failure (HF). Several aspects of HF modification have yet to be described regarding etiology-dependent outcome differences in the long-term.The Mannheim CArdiac Resynchronization TherApy RetrospeCtive ObservAtioNAl (MARACANA) Registry retrospectively included all patients provided with CRTs in our center from 2013 to 2021. CRT-D recipients (n = 380) were grouped to either ischemic cardiomyopathy (ICM, n = 206) or nonischemic cardiomyopathy (NICM, n = 174). Both groups were compared regarding survival, left ventricular ejection fraction (LVEF), hospitalizations due to HF, intrinsic and paced QRS width, NYHA classification, and several further aspects of HF modification in the long-term (59.1 ± 4.81 months).Patients with ICM were older (73.3 ± 8.4 versus 67.7 ± 10.8 years) and predominantly male (86.4 versus 74.7%) and presented with higher creatinine values (1.57 ± 0.92 versus 1.31 ± 0.66 mg/dL, each P < 0.05) at baseline. The mean survival for patients with NICM was better (51.9 ± 1.2 versus 54.4 ± 1.1 months, P = 0.03). Improvements in NYHA (2.93 ± 0.4 versus 2.79 ± 0.5-2.19 ± 0.7 versus 1.79 ± 0.7) and LVEF (26.4 ± 6.8 versus 27% ± 6.9% to 35.7 ± 9.6 versus 44 ± 11%, each P < 0.05) were similar for both groups after 5 years. Patients with ICM experienced more hospitalizations due to HF within the first year (odds ratio 1.9, P < 0.05), whereas electrical remodeling was more impressive for NICM (QRS width 157.1 ± 19.4 milliseconds versus intrinsic 116.6 ± 12.7 milliseconds and paced 131.9 ± 21 milliseconds after 5 years, both P < 0.05).Patients with HF might experience long-term improvements in functional status and left ventricular reverse remodeling following CRT-D, regardless of underlying etiology. Alterations in some aspects of HF modification could be influenced by time- and etiology-associated comorbidities.

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来源期刊
International heart journal
International heart journal 医学-心血管系统
CiteScore
2.50
自引率
6.70%
发文量
148
审稿时长
6-12 weeks
期刊介绍: Authors of research articles should disclose at the time of submission any financial arrangement they may have with a company whose product figures prominently in the submitted manuscript or with a company making a competing product. Such information will be held in confidence while the paper is under review and will not influence the editorial decision, but if the article is accepted for publication, the editors will usually discuss with the authors the manner in which such information is to be communicated to the reader.
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