Effect of resynchronization therapy stimulation site on the systolic function of heart failure patients
Effect of resynchronization therapy stimulation site on the systolic function of heart failure patients
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DOI：
10.1161/hc5001.102229
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发表时间：
2001-12-18
期刊：
影响因子：
37.8
通讯作者：
Spinelli, J
中科院分区：
文献类型：
--
作者：
Butter, C;Auricchio, A;Spinelli, J
背景-心脏起搏治疗（CRT）通过刺激左心室（LV）或双心室（biventricular，BV）改善心室传导延迟心力衰竭患者的收缩功能。最佳LV部位选择是CRT器械植入的主要临床关注点，然而，尚未确定血流动力学对LV刺激部位的依赖性，因此。本研究的目的是比较两个LV冠状静脉部位（游离壁和前壁）对CRT的血液动力学反应。方法和结果-研究了在PATH-CHF-II试验中登记的总共30名患者（平均NYHA分级，2.7平均QRS间期，152 ms;平均PR间期，194 ms）。CRT在VDD模式下以4个AV延迟进行LV和BV刺激。左心室刺激位于外侧游离壁或前壁，而右心室刺激固定在心尖附近。比较了LV部位CRT期间LV+dP/dt（max）和主动脉脉压较基线的变化。左心室和BV刺激游离壁部位产生的LV+dP/dt（max）显著增大（14%对6%，P
Background-Cardiac resynchronization therapy (CRT) improves systolic function in heart failure patients with ventricular conduction delay by stimulating the left ventricle (LV) or both ventricles (biventricular, BV). Optimal LV,site selection is of major clinical interest for CRT device implantation however, the dependence of hemodynamics on LV stimulation site has not been established, Thus. the objective of this study was to compare the hemodynamic response to CRT for 2 LV coronary vein sites: the free wall and anterior wall.Methods and Results-A total of 30 patients (mean NYHA class, 2.7 mean QRS interval, 152 ms; mean PR interval, 194 ms) enrolled in the PATH-CHF-II trial were studied. CRT was administered with LV and BV stimulation in VDD mode at 4 AV delays. LV stimulation was at the lateral free wall or anterior wall, whereas right ventricular stimulation was fixed near the apex. LV+dP/dt(max), and aortic pulse pressure changes from baseline during CRT were compared for LV sites. Free wall sites with LV and BV stimulation yielded significantly larger LV+dP/dt(max), (14% versus 6%, P