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首页> 外文期刊>PACE: Pacing and clinical electrophysiology >Prevalence of potential candidates for biventricular pacing among patients with known coronary artery disease: a prospective registry from a single center.
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Prevalence of potential candidates for biventricular pacing among patients with known coronary artery disease: a prospective registry from a single center.

机译：已知冠状动脉疾病患者中双心室起搏的潜在可能性的流行：来自单个中心的前瞻性登记。

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摘要

New forms of ventricular pacing are increasingly studied as an option in the management of patients with heart failure. Coronary artery disease (CAD) is the most frequent cause of heart failure, and patients with complete left or right bundle branch block (LBBB and RBBB) and a reduced left ventricular ejection fraction (LVEF) are the best candidates for this new therapy. However, the prevalence of this clinical presentation is uncertain. During a 1-year period, 433 patients with documented CAD (mean age 64 +/- 10 years, 79% men) who were referred for myocardial perfusion imaging were prospectively studied. All patients underwent a 2-day stress-rest gated 99mTc-Tetrofosmin SPECT study with evaluation of resting LV enddiastolic (LVEDV) and endsystolic (LVESV) volumes and LVEF. The resting ECG was examined in all patients for the presence of complete LBBB or RBBB. Of the 433 patients with CAD 36 patients (8.3%) had LBBB (n = 14) or RBBB (n = 22) and a QRS width > 120 ms. These 36 patients were in general older and more frequently had diabetes and atrial fibrillation. Patients with LBBB or RBBB had a significantly lower LVEF (41 +/- 16% vs 48 +/- 14%, P < 0.01) and significantly higher LV volumes compared to patients without LBBB or RBBB (177 +/- 79 mL vs 131 +/- 53 mL, P < 0.001 for LVEDV and 116 +/- 76 mL vs 73 +/- 49 mL, P < 0.001 for LVESV). In total, 112/433 (26%) had an LVEF < or = 40%; 16 had also a LBBB or RBBB (3.7% of the whole population, 14% of the patients with a LVEF < or = 40%). Within the group of patients with a LVEF > or = 40%, patients with BBB had comparable LVEF (26 +/- 9% vs 30 +/- 8%, P = NS) but significantly higher LVEDV and LVESV (230 +/- 70 mL vs 190 +/- 64 mL, P < 0.05 for LVEDV and 170 +/- 65 mL vs 135 +/- 56 mL, P < 0.05 for LVESV). In this prospective registry 3.7% of all patients with known CAD had LBBB or RBBB in combination with a LVEF < or = 40%. This represented 14% of all patients with a LVEF > or = 40%. These limited numbers should be kept in mind when considering biventricular pacing as a new therapeutic options in patients with heart failure.
机译：在心力衰竭患者的治疗中，越来越多地研究新的心室起搏形式。冠状动脉疾病（CAD）是最常见的心力衰竭原因，具有完全左或右束支传导阻滞（LBBB和RBBB）和左心室射血分数（LVEF）降低的患者是这种新疗法的最佳人选。但是，这种临床表现的普遍性尚不确定。在为期1年的时间里，前瞻性研究了433例记录有冠心病的CAD患者（平均年龄64 +/- 10岁，男性为79％）。所有患者均接受为期2天的应激性门控99mTc-四氟磷胺SPECT研究，评估静息期LV舒张期（LVEDV）和收缩期（LVESV）量及LVEF。检查所有患者的静息心电图是否存在完整的LBBB或RBBB。在433例CAD患者中，有36例（8.3％）患有LBBB（n = 14）或RBBB（n = 22），QRS宽度> 120 ms。这36名患者一般年龄较大，并且更常患有糖尿病和心房颤动。与没有BBBB或RBBB的患者相比，LBBB或RBBB的患者的LVEF显着降低（41 +/- 16％vs 48 +/- 14％，P <0.01），并且LV量显着更高（177 +/- 79 mL vs 131 +/- 53毫升，对于LVEDV和116 +/- 76毫升，P <0.001与73 +/- 49毫升，对于LVESV的P <0.001）总计112/433（26％）的LVEF <或= 40％; 16名患者还患有LBBB或RBBB（占总人口的3.7％，LVEF <或= 40％的患者占14％）。在LVEF>或= 40％的患者组中，BBB患者的LVEF相当（26 +/- 9％对30 +/- 8％，P = NS），但LVEDV和LVESV明显更高（230 +/- 70 mL对190 +/- 64 mL，对于LVEDV为P <0.05，对于170 +/- 65 mL对135 +/- 56 mL，对于LVESV为P <0.05）。在该前瞻性登记中，所有已知CAD患者中有3.7％的患者患有LBBB或RBBB，且LVEF≤40％。这占所有LVEF>或= 40％的患者的14％。当考虑将心室起搏作为心力衰竭患者的新治疗选择时，应牢记这些有限的数字。

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