Cardiac electrical and mechanical synchrony of super-responders to cardiac resynchronization therapy  

作　　者：Ke-Bei Li Zhi-Yong Qian Xue-Song Qian Yong Zhou Di-Di Zhu Yuan-Hao Qiu Yao Wang Xiao-Feng Hou Jian-Gang Zou Yu-Feng Sheng 

机构地区：[1]Department of Cardiology,The Affiliated Zhangjiagang Hospital of Soochow University,Zhangjiagang,Jiangsu 215600,China [2]Department of Cardiology,First Affiliated Hospital,Nanjing Medical University,Nanjing,Jiangsu 210029,China [3]Department of Cardiology,Zhongda Hospital Southeast University,Nanjing,Jiangsu 210029,China

出　　处：《Chinese Medical Journal》2020年第2期141-147,共7页中华医学杂志（英文版）

基　　金：This study was supported by the grants from the Science and Technology Department of Suzhou City(No.KJXW2017057);the Science and Technology Department of Jiangsu Province(No.BE2016764);from the Training Program of“the National Tutorial System”of Suzhou City.

摘　　要：Background:Super-responders(SRs)to cardiac resynchronization therapy(CRT)regain near-normal or normal cardiac function.The extent of cardiac synchrony of SRs and whether continuous biventricular(BIV)pacing is needed remain unknown.The aim of this study was to evaluate the cardiac electrical and mechanical synchrony of SRs.Methods:We retrospectively analyzed CRT recipients between 2008 and 2016 in 2 centers to identify SRs,whose left ventricular(LV)ejection fraction was increased to≥50%at follow-up.Cardiac synchrony was evaluated in intrinsic and BIV-paced rhythms.Electrical synchrony was estimated by QRS duration and LV mechanical synchrony by single-photon emission computed tomography myocardial perfusion imaging.Results:Seventeen SRs were included with LV ejection fraction increased from 33.0±4.6%to 59.3±6.3%.The intrinsic QRS duration after super-response was 148.8±30.0 ms,significantly shorter than baseline(174.8±11.9 ms,P=0.004,t=3.379)but longer than BIV-paced level(135.5±16.7 ms,P=0.042,t=2.211).Intrinsic LV mechanical synchrony significantly improved after super-response(phase standard deviation[PSD],51.1±16.5°vs.19.8±8.1°,P<0.001,t=5.726;phase histogram bandwidth(PHB),171.7±64.2°vs.60.5±22.9°,P<0.001,t=5.376)but was inferior to BIV-paced synchrony(PSD,19.8±8.1°vs.15.2±6.4°,P=0.005,t=3.414;PHB,60.5±22.9°vs.46.0±16.3°,P=0.009,t=3.136).Conclusions:SRs had significant improvements in cardiac electrical and LV mechanical synchrony.Since intrinsic synchrony of SRs was still inferior to BIV-paced rhythm,continued BIV pacing is needed to maintain longstanding and synchronized contraction.

关 键 词：CARDIAC RESYNCHRONIZATION Super-responders ELECTRICAL synchrony MECHANICAL synchrony 

分 类 号：R541[医药卫生—心血管疾病]