Sixty-one heart failure patients following standard indication for CRT received twice GMPS as pre- and post-CRT evaluations. The patients with an absolute reduction of scar ≥ 10% after CRT were classified as the SR group while the rest were classified as the non-SR group. The SR group (N = 22, 36%) showed more improvement on LV function (∆LVEF: 18.1 ± 12.4 vs 9.4 ± 9.9 %, P = 0.007, ∆ESV: - 91.6 ± 52.6 vs - 38.1 ± 46.5 mL, P < 0.001) and dyssynchrony (ΔPSD: - 26.19 ± 18.42 vs - 5.8 ± 23.0°, P < 0.001, Δ BW: - 128.7 ± 82.8 vs - 25.2 ± 109.0°, P < 0.001) than non-SR group (N = 39, 64%). Multivariate logistic regression analysis showed baseline QRSd (95% CI 1.019-1.100, P = 0.006) and pre-CRT Reduced Wall Thickening (RWT) (95% CI 1.016-1.173, P = 0.028) were independent predictors for the development of SR.
More than one third of patients showed SR after CRT who had more post-CRT improvement on LV function and dyssynchrony than those without SR. Wider QRSd and higher RWT before CRT were related to the development of SR after CRT.
结果:61名符合CRT标准适应症的心力衰竭患者接受两次GMPS作为CRT前后评估。CRT后疤痕绝对减少≥10%的患者被归类为SR组,其余患者被归类为非SR组。SR组(N=22,36%)显示出更多的LV功能改善(ΔLVEF:18.1±12.4vs9.4±9.9%,P=0.007,ΔESV:-91.6±52.6vs-38.1±46.5mL,P<0.001)和不同步(ΔPSD:-26.19±18.42vs-5.8±23.0°,P<0.001,ΔBW:-128.7±82.8vs-25.2±109.0°,P<0.001)高于非SR组(N=39,64%)。多因素logistic回归分析显示,基线QRSd(95%CI1.019-1.100,P=0.006)和CRT前减少壁增厚(RWT)(95%CI1.016-1.173,P=0.028)是SR发展的独立预测因素。
结论:超过三分之一的患者在CRT后表现出SR,与没有SR的患者相比,CRT后的LV功能和不同步改善更多。CRT前较宽的QRSd和较高的RWT与CRT后SR的发展有关。