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目的评价合并心力衰竭的常规起搏器患者升级为CRT逆转左室重构的作用。方法入选起搏依赖、合并心力衰竭的常规起搏器患者,将其升级为CRT。观察手术前后患者QRS时限、左室舒张末期内径(LVEDD)、射血分数(LVEF)与肺动脉收缩压(SPAP)等心脏结构和功能的变化情况。结果常规起搏器升级为CRT后,QRS时限较前明显缩短,由术前的155.2±27.1ms缩短至130±15.0ms,p<0.01。随访至术后6月,CRT有效率为68%(18/25例),LVEDD[(64.6±8.5)vs(57.56±9.5),p<0.01]显著缩小,LVEF[(29.4±3.8)vs(32.5±4.1),p<0.01]显著增加,SPAP[(46.6±12.8)vs(44.5±13.1),p<0.01]也较前下降。结论对于起搏依赖、合并心力衰竭的常规起搏器患者,升级为CRT可显著改善心功能、逆转心肌重构。
Objective To evaluate the role of CRT in reversing left ventricular remodeling in patients with conventional pacemaker with heart failure. Methods Patients with pacemaker-dependent, conventional pacemaker with heart failure were enrolled and upgraded to CRT. The changes of cardiac structure and function such as QRS duration, left ventricular end-diastolic diameter (LVEDD), ejection fraction (LVEF) and pulmonary arterial pressure (SPAP) were observed before and after operation. Results After the conventional pacemaker was upgraded to CRT, the QRS duration was significantly shortened from 155.2 ± 27.1 ms preoperatively to 130 ± 15.0 ms, p <0.01. After 6 months of follow-up, the effective rate of CRT was 68% (18/25), LVEDD [(64.6 ± 8.5) vs (57.56 ± 9.5), p <0.01] 32.5 ± 4.1), p <0.01]. SPAP [(46.6 ± 12.8) vs (44.5 ± 13.1), p <0.01] also decreased compared with the former. Conclusions For patients with pacing-dependent, conventional pacemaker with heart failure, upgrading to CRT significantly improves cardiac function and reverses cardiac remodeling.