Therapeutic Analysis on Cardiac Resynchronization Therapy in Heart Failure Patients with Narrow QRS Wave
Li Shujuan
Chen Fengying
Cui Xiaoying
Niu Junyi
Zhao Wanglei
Wen Pei
Abstract：Objective To observe the efficacy of cardiac resynchronization therapy (CRT)in heart failure (HF)patients with narrow QRS wave. Methods Fifty-seven patients with HF were selected from September 2010 to September 2015 and divided into group A (QRS≥120 ms,n=46)and group B (QRS<120 ms,n=11)according to the QRS time.They were treated with CRT. Forty-five healthy individuals were as the controls (group C).The real-time three-dimensional echocardiography (RT-3DE),electrocardio-gram (ECG)were analyzed before and after 3 months of CRT.The levels of plasma N-terminal pro-brain natriuretic peptide (NT- proBNP), high sensitivity C-reactive protein (hs-CRP)were observed. The left ventricular ejection fraction (LVEF),left ventricular end-di-astolicolume (LVEDV),end-systolic volume (LVESV),systolic synchronicity parameters,systolic synchronicity parameters,6 mi-nutes walk test (6MWT)were evaluated. Results Before operation,al the indexes such as cardiac function NYHA classification, Minnesota scores,6MWT,and LVEF,LVEDV,LVESV,heart movement synchronization index,plasma NT-proBNP and hs-CRP lev-els in group A and group B were significantly increased compared with group C (P<0.05 or P<0.01). There was no difference be-tween group A and group B (P>0.05). After 3 months of operation,there was difference in cardiac function NYHA classification, Minnesota scores,6 MWT,and LVEF,LVEDV,LVESV,heart movement synchronization index,plasma NT-proBNP and hs-CRP levels in group A and group B compared with before operation(P<0.05). There was no significant difference in the indexes between group A and group B after 3 months of operation (P>0.05). Conclusion Real-time three-dimensional echocardiography as a noninvasive,safe and reliable,strong repeatability of the testing means,is a reliable method in evaluating cardiac systolic synchroni-zation. The levels of plasma concentration of NT-proBNP and hs- CRP rise,with the increase of volume or pressure load,and relat-ed to left ventricular remodeling and cardiac insufficiency of occurrence,development and the outcome,they can reflect the severity of heart failure and dangerous degree,and predict postoperative effect of CRT. Use of RT-3DE combined with the NT–proBNP and hs-CRP can screening suitable patients for clinicians in CRT,can improve the CRT curative effect,and HF patients with narrow QRS wave and left ventricular asynchronous can also benefit by CRT.
Keywords：heart failurecardiac resynchronization therapynarrow QRS wavehigh-sensitivity C-reactive proteinN-terminal pro-brain natriuretic peptide
Publication Date：2017-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 387-392 )