心脏再同步化疗法中左束支区起搏与双心室起搏对发病率和死亡率的影响。

IF 3.1 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Drugs and Therapy Pub Date : 2024-06-01 Epub Date: 2022-12-02 DOI:10.1007/s10557-022-07410-3

Yixiu Liang, Zilong Xiao, Xi Liu, Jingfeng Wang, Ziqing Yu, Xue Gong, Hongyang Lu, Shengwen Yang, Min Gu, Lei Zhang, Minghui Li, Lei Pan, Xiao Li, Xueying Chen, Yangang Su, Wei Hua, Junbo Ge

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引用次数: 0

摘要

背景：左束支区起搏（LBBAP）已成为心脏再同步化治疗（CRT）中双心室起搏（BVP）的替代方案。我们的目的是比较在接受 CRT 植入术的患者中，LBBAP 与 BVP 的相关发病率和死亡率：我们回顾性地招募了在两个高容量植入中心接受 CRT 的连续患者。主要终点是全因死亡和心衰住院的复合终点，次要终点是全因死亡：共纳入了 491 名接受 CRT 的患者（154 名通过 LBBAP，337 名通过 BVP），中位随访时间为 31 个月。LBBAP组有21名（13.6%）患者达到主要终点，而BVP组有74名（22.0%）患者达到主要终点[危险比（HR）0.70，95%置信区间（CI）0.43-1.14，P = 0.15]。LBBAP组有10人（6.5%）死亡，而BVP组有31人（9.2%）死亡（HR 0.91，95% CI 0.44-1.86，P = 0.79）。经多变量考克斯回归（HR 0.74，95% CI 0.45-1.23，P = 0.24；HR 0.77，95% CI 0.36-1.67，P = 0.51）或倾向评分匹配（HR 0.72，95% CI 0.41-1.29，P = 0.28；HR 0.69，95% CI 0.29-1.65，P = 0.40）后，LBBAP和BVP的主要终点或次要终点风险均无明显差异：结论：在有CRT适应症的患者中，LBBAP与BVP相比，对发病率和死亡率的影响相当。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Left Bundle Branch Area Pacing versus Biventricular Pacing for Cardiac Resynchronization Therapy on Morbidity and Mortality.

Background: Left bundle branch area pacing (LBBAP) has emerged as an alternative to biventricular pacing (BVP) for cardiac resynchronization therapy (CRT). We aimed to compare the morbidity and mortality associated with LBBAP versus BVP in patients undergoing CRT implantation.

Methods: Consecutive patients who received CRT from two high-volume implantation centers were retrospectively recruited. The primary endpoint was a composite of all-cause death and heart failure hospitalization, and the secondary endpoint was all-cause death.

Results: A total of 491 patients receiving CRT (154 via LBBAP and 337 via BVP) were included, with a median follow-up of 31 months. The primary endpoint was reached by 21 (13.6%) patients in the LBBAP group, as compared with 74 (22.0%) patients in the BVP group [hazard ratio (HR) 0.70, 95% confidence interval (CI) 0.43-1.14, P = 0.15]. There were 10 (6.5%) deaths in the LBBAP group, as compared with 31 (9.2%) in the BVP group (HR 0.91, 95% CI 0.44-1.86, P = 0.79). No significant difference was observed in the risk of either the primary or secondary endpoint between LBBAP and BVP after multivariate Cox regression (HR 0.74, 95% CI 0.45-1.23, P = 0.24, and HR 0.77, 95% CI 0.36-1.67, P = 0.51, respectively) or propensity score matching (HR 0.72, 95% CI 0.41-1.29, P = 0.28, and HR 0.69, 95% CI 0.29-1.65, P = 0.40, respectively).

Conclusion: LBBAP was associated with a comparable effect on morbidity and mortality relative to BVP in patients with indications for CRT.

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来源期刊

Cardiovascular Drugs and Therapy 医学-心血管系统

CiteScore

8.30

自引率

0.00%

发文量

110

审稿时长

4.5 months

期刊介绍： Designed to objectively cover the process of bench to bedside development of cardiovascular drug, device and cell therapy, and to bring you the information you need most in a timely and useful format, Cardiovascular Drugs and Therapy takes a fresh and energetic look at advances in this dynamic field. Homing in on the most exciting work being done on new therapeutic agents, Cardiovascular Drugs and Therapy focusses on developments in atherosclerosis, hyperlipidemia, diabetes, ischemic syndromes and arrhythmias. The Journal is an authoritative source of current and relevant information that is indispensable for basic and clinical investigators aiming for novel, breakthrough research as well as for cardiologists seeking to best serve their patients. Providing you with a single, concise reference tool acknowledged to be among the finest in the world, Cardiovascular Drugs and Therapy is listed in Web of Science and PubMed/Medline among other abstracting and indexing services. The regular articles and frequent special topical issues equip you with an up-to-date source defined by the need for accurate information on an ever-evolving field. Cardiovascular Drugs and Therapy is a careful and accurate guide through the maze of new products and therapies which furnishes you with the details on cardiovascular pharmacology that you will refer to time and time again.