心肌收缩力调节器治疗心力衰竭临床应用  

Clinical application of cardiac contractility modulation for treating chronic heart failure in Chinese patients

作　　者：华伟[1] 汤宝鹏[2] 王景峰[3] 苏晞[4] 袁祖贻[5] 薛小临 郭涛 张明国[7] 陈样新[3] 张疆华[2] 邓宇 牛红霞[1] 张澍[1] Hua Wei;Tang Baopeng;Wang Jingfeng;Su Xi;Yuan Zuyi;Xue Xiaolin;Guo Tao;Zhang Mingguo;Chen Yangxin;Zhang Jianghua;Deng Yu;Niu Hongxia;Zhang Shu(Center of Arrhythmia,Fuwai Hospital,State Key Laboratory of Cardiovascular Disease,National Center for Cardiovascular Diseases,Chinese Academy of Medical Sciences,Peking Union Medical College,Beijing 100037,China;Department of Pacing and Electrophysiology,Department of Cardiac Electrophysiology and Remodeling,The First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China;Department of Cardiology,The Sun Yat-sen Memorial Hospital of Sun Yat-sen University,Guangzhou 510120,China;Department of Cardiology,Wuhan Asia Heart Hospital,Wuhan 430022,China;Department of Cardiology,The First Affiliated Hospital of Xi′an Jiaotong University,Xi′an 710061,China;Department of Cardiology,Fuwai Yunnan Cardiovascular Hospital,Kunming 650000,China;Department of Cardiology,The First Affiliated Hospital of Kunming Medical University,Kunming 650032,China)

机构地区：[1]中国医学科学院,北京协和医学院,国家心血管病中心,心血管疾病国家重点实验室,阜外医院心律失常中心,北京100037 [2]新疆医科大学第一附属医院心脏中心起搏电生理科,新疆心电生理与心脏重塑重点实验室,乌鲁木齐830054 [3]中山大学孙逸仙纪念医院心内科,广州510120 [4]武汉亚洲心脏病医院心内科,武汉430022 [5]西安交通大学第一附属医院心内科,西安710061 [6]云南省阜外心血管病医院心内科,昆明650000 [7]昆明医科大学第一附属医院心内科,昆明650032

出　　处：《中华心律失常学杂志》2022年第6期529-533,共5页Chinese Journal of Cardiac Arrhythmias

摘　　要：目的评价心肌收缩力调节器(CCM)用于治疗药物无反应心力衰竭患者的初步疗效。方法本文为回顾性研究。连续收集全国46个中心2021年1月至2022年5月行CCM植入的71例患者资料,分析术前以及术后出院前左心室射血分数(LVEF)、左心室收缩末期内径(LVESD)及左心室舒张末期内径(LVEDD)的变化情况。结果最终纳入65例基线资料齐全的患者,年龄(56.5±13.8)岁,其中男50例(50/65,76.9%)。术后患者的LVEF由29.0%±5.9%升高至38.5%±8.5%,提高9.5%±8.8%(P<0.001);LVESD由(58.3±7.0)mm减小至(52.0±8.2)mm,降低(6.2±6.4)mm(P<0.001);LVEDD由(66.6±6.3)mm减小至(63.4±6.7)mm,降低(3.1±4.9)mm(P=0.001)。无严重手术相关并发症发生。结论CCM植入后能迅速且有效改善慢性心力衰竭患者心功能,逆转心脏重构。Objective To investigate the effectiveness of cardiac contractility modulation(CCM)for treating advanced heart failure patients.Methods We retrospectively and consecutively enrolled 71patients who underwent CCM implantation in 46 centers in China through January 2021 to May 2022.Left ventricular ejection fraction,left ventricular end-systolic diameter,and left ventricular end-diastolic diameter before and after implantation of patients were collected and compared.Results After excluding 6 patients with missing baseline information,a total of 65 patients were finally enrolled.Fifty(50/65,76.9%)of them were male,with a mean age of(56.5±13.8)years.Compared to pre-implantation,mean left ventricular ejection fraction of patients before discharge increased from 29.0%±5.9%to 38.5%±8.5%(mean difference of 9.5%±8.8%,P<0.001).Meanwhile,left ventricular end systolic diameter decreased from(58.3±7.0)mm to(52.0±8.2)mm[mean difference of(6.2±6.4)mm,P<0.001],and left ventricular end diastolic diameter decreased from(66.6±6.3)mm to(63.4±6.7)mm[mean difference of(3.1±4.9)mm,P=0.001].Conclusion CCM could promptly and effectively contributing to structural and functional reverse remodeling in chronic heart failure patients.

关 键 词：心力衰竭 心肌收缩力调节器 左心室射血分数 左心室收缩末期内径 左心室舒张末期内径 

分 类 号：R541.6[医药卫生—心血管疾病]