Relationship of Reverse Anatomical Remodeling and Ventricular Arrhythmias After Cardiac Resynchronization
Relationship of Reverse Anatomical Remodeling and Ventricular Arrhythmias After Cardiac Resynchronization
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DOI：
10.1111/j.1540-8167.2008.01317.x
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发表时间：
2009-03-01
影响因子：
2.7
通讯作者：
Lerman, Bruce B.
中科院分区：
文献类型：
--
作者：
Markowitz, Steven M.;Lewen, Jason M.;Lerman, Bruce B.
室性心律失常和逆向重构：引言：心脏复律（CRT）影响心力衰竭患者的逆向解剖重构。在一些临床试验中，CRT也与较少的室性心律失常和减少猝死有关，但CRT抗心律失常作用的预测因子和机制尚未得到很好的定义。本研究的目的是探讨逆向解剖重构与室性心律失常的关系，在CRT patients.Methods和结果：进行了回顾性分析的InSync III侯爵研究，前瞻性，随机，多中心CRT试验。在基线和CRT 6个月后获得了198例患者的超声心动图数据，解剖学应答者定义为左心室收缩末期容积（LVESV）减少≥ 15%。解剖学应答者（n = 71，36%）表现出比无应答者少29%的单次室性早搏（PVC）（P = 0.0001），少48%的PVC运行（p = 0.0096），以及更少的室性心动过速或室颤（VT/VF）（P = 0.050）治疗发作。多元回归分析表明，应答者状态可显着预测单次PVC和PVC运行。性别是最重要的预测治疗VT/VF与女性没有发作超过6个月的follow-up.Conclusions：CRT的解剖反应者表现出显着减少单PVC和运行的PVC。这些观察结果的含义是解剖重构与电重构有关。（J.E. Vasc Electrophysiol，第20卷，第100页）。293-298，2009年3月）。
Ventricular Arrhythmias and Reverse Remodeling.Introduction: Cardiac resynchronization (CRT) affects reverse anatomical remodeling in patients with heart failure. CRT has also been associated with fewer ventricular arrhythmias and reduced sudden death in some clinical trials, but the predictors and mechanism of the antiarrhythmic actions of CRT have not been well defined. The purpose of this study is to investigate the relationship of reverse anatomical remodeling to ventricular arrhythmias in CRT patients.Methods and Results: A retrospective analysis was performed of the InSync III Marquis study, a prospective, randomized, multicenter CRT trial. Echocardiographic data from 198 patients were obtained at baseline and after 6 months of CRT, and anatomical responders were defined as a reduction in left ventricular end systolic volume (LVESV) of >= 15%. Anatomical responders (n = 71, 36%) demonstrated 29% fewer single premature ventricular contractions beats (PVCs) (P = 0.0001), 48% fewer PVC runs (p = 0.0096), and fewer treated episodes of ventricular tachycardia or fibrillation (VT/VF) (P = 0.050) than nonresponders. Multiple regression analysis demonstrated that responder status significantly predicted single PVCs and PVC runs. Gender was the most important predictor of treated VT/VF with females having no episodes over 6 months of follow-up.Conclusions: Anatomic responders to CRT demonstrate significantly fewer single PVCs and runs of PVCs. The implication of these observations is that anatomic remodeling is linked to electrical remodeling.(J Cardiovasc Electrophysiol, Vol. 20, pp. 293-298, March 2009).