心肌收缩力调节器植入治疗心力衰竭的早期临床结果分析  

Analysis of early clinical results of cardiac contractility modulation implantation in the treatment of heart failure

作　　者：苏蓉[1] 林玲[1] 张明国[1] 杨爱玲[1] 李云飞[1] 陈韵羽[1] SU Rong;LIN Ling;ZHANG Ming-guo;YANG Ai-ling;LI Yun-fei;CHEN Yun-yu(Department of Geriatric Cardiology,the First Affiliated Hospital of Kunming Medical University,Kunming 650500,China)

机构地区：[1]昆明医科大学第一附属医院老年心脏内科,云南省昆明市650500

出　　处：《中国心血管病研究》2025年第1期35-39,共5页Chinese Journal of Cardiovascular Research

基　　金：云南省基础研究计划-昆医联合专项[2019FE001(-033)]。

摘　　要：目的探讨心肌收缩力调节器(CCM)治疗慢性心力衰竭患者的早期临床疗效。方法回顾性分析2022年2至2023年12月在昆明医科大学第一附属医院进行CCM植入的慢性心力衰竭患者的临床资料。术后1个月及6个月进行随访,比较患者术前、术后1个月及术后6个月纽约心脏协会(NYHA)心功能分级、左心房内径(LAD)、左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)、左心室舒张末期内径(LVEDD)左心室射血分数(LVEF)值等。记录术中、术后并发症及不良事件发生情况。结果纳入22例成功植入CCM且资料齐全的患者。其中男性15例,年龄(52±10)岁,20例患者为扩张型心肌病,2例为其他病因导致的慢性心力衰竭患者。结果显示,与术前相比,LVEDD在术后1个月及6个月逐渐缩小[(63.0±9.8)mm及(59.2±10.6)mm比(65.6±8.7)mm,P<0.05],术后6个月LVEDV较术前减少[(201.2±85.7)ml比(247.7±75.2)ml,P<0.05],LVESV术后1个月及6个月较术前降低[(130.3±61.3)ml]及[(117.5±69.2)ml比(166.9±64.6)ml,P<0.05];术后LAD较术前均缩小[(39.0±7.3)mm及(38.3±8.1)mm比(43.8±7.6)mm,P<0.05];而LVEF术后1个月及6个月较术前明显升高[(42.0±5.8)%及(47.3±9.2)%比(31.6±7.2)%,P<0.05],NYHAⅢ级和Ⅳ级患者的比例较术前下降(P<0.05)。术中无相关并发症发生。出院后2例患者因程控发现参数异常,行植入式心律转复除颤器(ICD)电极调整术。随访期间患者无死亡,3例患者因慢性心力衰竭急性加重再次入院,4例(18.2%)患者因其他病因再住院。结论慢性心力衰竭患者CCM植入术后早期促进心脏逆重构,改善患者心功能。Objective To investigate the early clinical results of myocardial systolic regulator(CCM)in patients with heart failure.Methods The clinical data of patients with chronic heart failure who underwent CCM implantation in the First Affiliated Hospital of Kunming Medical University from February 2022 to December 2023 were retrospectively analyzed.The patients were followed up 1 month and 6 months after CCM implantation.New York Heart Association(NYHA)cardiac function classification,left atrial diameter(LAD),left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV),left ventricular end-diastolic diameter(LVEDD)and left ventricular ejection fraction(LVEF)were compared before CCM implantation,1 month and 6 months after CCM implantation.Intraoperative and postoperative complications and adverse events were recorded.Results The 22 patients with CCM implantation and complete data were included.Among them,15 were males,aged(52±10)years,20 were patients with dilated cardiomyopathy,and 2 were patients with chronic heart failure caused by other causes.The results showed that LVEDD decreased gradually at 1 and 6 months after CCM implantation[(63.0±9.8)mm and(59.2±10.6)mm vs.(65.6±8.7)mm,P<0.05].LVEDV decreased 6 months after CCM implantation compared with that before implantation[(201.2±85.7)ml vs.(247.7±75.2)ml,P<0.05].LVESV decreased at 1 and 6 months after implantation compared with that before operation[(130.3±61.3)ml and(117.5±69.2)ml vs.(166.9±64.6)ml,P<0.05].The postoperative LAD was smaller than that before implantation[(39.0±7.3)mm and(38.3±8.1)mm vs.(43.8±7.6)mm,P<0.05].LVEF was significantly higher 1 and 6 months after CCM implantation than that before implantation[(42.0±5.8)%and(47.3±9.2)%vs.(31.6±7.2)%,P<0.05]and the proportion of NYHAⅢ-Ⅳpatients decreased compared with before CCM implantation(P<0.05).No complications occurred during the operation.After discharge,2 patients were found to have abnormal parameters due to program control and underwent electrode adjustm

关 键 词：心力衰竭 心肌收缩调节器 左心室射血分数 

分 类 号：R541.6[医药卫生—心血管疾病]