引用本文:张海峰,王景峰.心脏再同步化治疗的认识和存在问题[J].中国临床新医学,2019,12(5):494-498.
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心脏再同步化治疗的认识和存在问题
张海峰,王景峰
510120  广州,中山大学孙逸仙纪念医院心内科
摘要:
[摘要] 心脏再同步化治疗(cardiac resynchronization therapy,CRT)是有效治疗心力衰竭的非药物措施。CRT主要适应证为NYHA分级Ⅱ~Ⅳ级、窦性心律和完全性左束支传导阻滞患者,也适用于部分非左束支传导患者。尽管CRT在多数患者中可明显改善患者预后,但在部分患者中效果不佳,表现为CRT无反应者。如何减少CRT无反应者比例是CRT临床应用中的重要问题。该文对CRT治疗心力衰竭机制、目前主要临床研究结果和CRT无反应的可能原因及解决方案作一综述。
关键词:  慢性心力衰竭  束支传导阻滞  心脏再同步化治疗
DOI:10.3969/j.issn.1674-3806.2019.05.06
分类号:R 541.6+1
基金项目:
Cardiac resynchronization therapy: current understanding and issues
ZHANG Hai-feng, WANG Jing-feng
Department of Cardiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510120, China
Abstract:
[Abstract] Cardiac resynchronization therapy(CRT) is an effective non-drug strategy for patients with chronice heart failure(CHF). It is highly recommended to treat CHF patients with NYHA class Ⅱ~Ⅳ, sinus rhythm and left bundle branch block. It can also be used in some non-left bundle branch block CHF patients. Althought CRT is effective in most patients, there are still some CHF patients who are not significantly improved by it(CRT nonresponders). How to reduce the proportion of CRT nonresponders is an inportant issue in the clinical application of CRT. In this review focus on the mechanisms of CRT, the results of CRT clinical trials, and the causes and solutions for CRT nonresponders.
Key words:  Chronic heart failure(CHF)  Bundle branch block  Cardiac resynchronization therapy(CRT)