Predictor Analysis of Left Ventricular Reverse Remodeling in Patients With Ⅲ° Atrio-ventricular Block Combining Left Ventricular Systolic Dysfunction After Cardiac Resynchronization Therapy
10.3969/j.issn.1000-3614.2017.08.009
- VernacularTitle:心脏再同步化治疗逆转合并左心室收缩功能不全的三度房室传导阻滞患者左心室重构的预测因素分析
- Author:
Cuiping XIE
;
Kangyu CHEN
;
Ji YAN
;
Jian XU
;
Hao SU
;
Fei YU
;
Hongjun ZHU
;
Wei SHEN
;
Chunsheng AN
;
Dongmei YANG
- Keywords:
Cardiac resynchronization threapy;
Atrio-ventricular block;
Ventricular remodeling
- From:
Chinese Circulation Journal
2017;32(8):766-770
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To analyze the predictors of left ventricular reverse remodeling in patients with III? atrio-ventricular block (AVB) combining left ventricular systolic dysfunction after cardiac re-synchronization therapy (CRT). Methods: A total of 65 III? AVB patients received CRT in our hospital from 2009-01 to 2015-05 were enrolled. Clinical information before and after the operation were recorded. Left ventricular reverse remodeling was deifned by left ventricular end systolic volume (LVESV) decreased 15% or left ventricular ejection fraction (LVEF) increased≥5% at 12 months after CRT. The patients were divided into 2 groups: Reversal group,n=36 and No reversal group,n=29. Clinical condition was compared between 2 groups, predictors for CRT reversing left ventricular remodeling were evaluated by two classiifcation Logistic regression analysis. Results: The patients' average age was (62±14) years and 36/65 (55.4%) with reverse remodeling. In Reversal group, the ratios of female (P=0.011), baseline QRS width>120ms (P=0.001), inter-ventricular mechanical delay (IVMD)≥40 ms (P=0.027) and standard deviation of time-to-minimum systolic volume of 16 segments [Tmsv16-SD (%R-R)≥8.3%, (P=0.001)] were higher than those in No reversal group. Two classiifcation Logisitic regression analysis indicated that female (OR=6.228, 95%CI 1.561-24.842, P=0.01), QRS duration>120 ms (OR=7.778, 95% CI 1.996-30.769,P=0.003) and Tmsv16-SD (%R-R)≥8.3% (OR=8.134, 95% CI 2.064-32.057,P=0.003) were the independent predictors for ventricular reverse remodeling . Conclusion: Female, QRS>120ms and Tmsv16-SD (%R-R)≥8.3% could be used as the predictors for CRT reversing left ventricular remodeling in III? AVB patients combining left ventricular systolic dysfunction.
