Objective To observe the efficacy of cardiac resynchronization therapy( CRT ) in the treatment of patients with mild chronic heart failure. Methods Seven dilated cardiomyopathy patients with mild chronic heart failure and left bundle branch block received CRT,and followed up for 12 months. Doppler echocardiograms were recorded at baseline,before hospital discharge,and on the 12th month after operation. Results There were no patients hospitalized again for heart failure during the 12-month follow-up,and the patients' exercise capacity was improved. Compared with baseline,left ventricular end-diastolic dimension( LVEDD ) and mitral regurgitation( MR ) were significantly decreased ( P <0.05 ),while left ventricular ejection fraction( LVEF ),left ventricular end-systolic dimension( LVESD ) and left ventricular fraction shortening( LVFS ) did not change before hospital discharge( P > 0. 05 ). On the 12th month after operation, LVEF and LVFS were significantly increased( P < 0.05 ) while LVESD, LVEDD and MR were significantly decreased compared with baseline( P < 0. 05 ). The change of LVEDD on the 12th month after operation was positive correlated with QRS duration at baseline( P <0.05 ). Conclusion CRT can improve ventricular structure and function in dilated cardiomyopathy patients with mild chronic heart failure and left bundle branch block.%目的 观察心脏再同步化治疗(CRT)轻度慢性心力衰竭的应用效果.方法 轻度慢性心力衰竭伴左束支传导阻滞患者7例,均为扩张型心肌病,给予抗心力衰竭药物治疗,并植入三腔起搏器,定期随访,观察术前、术后出院前和术后12个月心脏结构和功能.结果 随访12个月无1例因心力衰竭再住院,活动耐量明显提高.术后出院前左室舒张末内径(LVEDD)和二尖瓣反流量(MR)较术前明显改善(P＜0.05),而左室射血分数(LVEF)、左室收缩末内径(LVESD)、左室短轴缩短率(LVFS)与术前比较无明显变化(P＞0.05);术后12个月,LVEF、LVFS较术前明显增加(P＜0.05),LVESD、LVEDD和MR较术前明显减少(P＜0.05).术后12个月,LVEDD减少值与术前QRS波宽度呈正相关(P＜0.05).结论 CRT治疗扩张型心肌病伴轻度慢性心力衰竭和左束支传导阻滞患者能改善心脏功能,逆转心室重构.
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