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Predictive factors and clinical effect of optimized cardiac resynchronization therapy

机译：优化心脏再同步治疗的预测因素和临床效果

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The aim of this study was to assess the effectiveness of cardiac resynchronization therapy (CRT) by intracardiac delay optimization using echocardiography. Sixty-five patients were implanted with a CRT device randomly assigned to receive simultaneous biventricular pacing or echo-optimized sequential CRT. Forty-two patients were defined as responders and 23 patients were classified as non-responders. During a 12-month follow-up period, the positive response rate, QRS duration, New York Heart Association class, mitral insufficiency grade, left ventricular end-systolic volume and LV end-diastolic volume were similar in the optimized and non-optimized groups (P>0.05), whereas 6-minute walking distance, quality-of-life score, left ventricular (LV) ejection fraction and aortic velocity time integral were significantly improved in the optimized group (P<0.05). The baseline QRS durations of the responders and non-responders were similar (P>0.05), whereas heart failure aetiology, clinical and echocardiographic measurements showed significant differences (P<0.05). The mean decrease in QRS duration after 12 months of CRT used for separating responders and non-responders was significantly different (P<0.05), and significant differences were observed in the mean decrease of QRS duration between responders and non-responders (P<0.05). Echocardiographic optimization may further improve the effectiveness of CRT. Moreover, severe mitral regurgitation and greater LV volume are likely to indicate a poor response to CRT.
机译：这项研究的目的是通过超声心动图心内延迟优化评估心脏再同步治疗（CRT）的有效性。 65位患者植入了随机分配的CRT设备，以同时接受双心室起搏或回声优化的连续CRT。将42例患者定义为有反应者，将23例患者划分为无反应者。在12个月的随访期内，优化组和非优化组的阳性反应率，QRS持续时间，纽约心脏协会分类，二尖瓣关闭不全等级，左心室收缩末期容积和左室舒张末期容积相似。 （P> 0.05），而优化组的6分钟步行距离，生活质量评分，左心室（LV）射血分数和主动脉速度时间积分显着改善（P <0.05）。反应者和非反应者的基线QRS持续时间相似（P> 0.05），而心力衰竭的病因，临床和超声心动图测量结果显示显着差异（P <0.05）。 CRT用于分隔反应者和非反应者的12个月后QRS持续时间的平均减少有显着差异（P <0.05），并且反应者和非反应者之间QRS持续时间的平均减少有显着差异（P <0.05） ）。超声心动图优化可以进一步提高CRT的有效性。此外，严重的二尖瓣关闭不全和左室容量增大可能表明对CRT的反应较差。

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