The effect of cardiac resynchronization on morbidity and mortality in heart failure
The effect of cardiac resynchronization on morbidity and mortality in heart failure
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DOI：
10.1056/nejmoa050496
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发表时间：
2005-04-14
影响因子：
158.5
通讯作者：
Khan, NK
中科院分区：
文献类型：
--
作者：
Cleland, JGF;Daubert, J;Khan, NK
研究背景心脏再同步化治疗可减轻因左室收缩功能不全和心脏不同步引起的心力衰竭患者的症状和改善左心功能。我们评估了其对发病率和死亡率的影响。方法将接受标准药物治疗的因左室收缩功能不全和心脏不同步所致的纽约心脏协会III级或IV级心力衰竭患者随机分为单纯药物治疗组和心脏再同步化治疗组。主要终点是因任何原因死亡或因重大心血管事件而意外住院的时间。结果共纳入813例患者，平均随访29.4个月。心脏再同步化组有159名患者达到了主要终点，而药物治疗组有224名患者达到了主要终点(39%比55%；风险比0.63；95%可信区间0.51到0.77；P
BackgroundCardiac resynchronization reduces symptoms and improves left ventricular function in many patients with heart failure due to left ventricular systolic dysfunction and cardiac dyssynchrony. We evaluated its effects on morbidity and mortality.MethodsPatients with New York Heart Association class III or IV heart failure due to left ventricular systolic dysfunction and cardiac dyssynchrony who were receiving standard pharmacologic therapy were randomly assigned to receive medical therapy alone or with cardiac resynchronization. The primary end point was the time to death from any cause or an unplanned hospitalization for a major cardiovascular event. The principal secondary end point was death from any cause.ResultsA total of 813 patients were enrolled and followed for a mean of 29.4 months. The primary end point was reached by 159 patients in the cardiac-resynchronization group, as compared with 224 patients in the medical-therapy group (39 percent vs. 55 percent; hazard ratio, 0.63; 95 percent confidence interval, 0.51 to 0.77; P