Effect of cardiac resynchronization therapy on vascular endothelial function in patients with congestive heart failure
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摘要: 目的:探讨心脏再同步化治疗(CRT)对充血性心力衰竭(心衰)患者内皮功能的影响。方法:扩张型心肌病并发心衰患者分为药物治疗组(10例)和CRT+药物治疗组(12例),分别在治疗前、治疗12周末,检测心脏超声、血管内皮功能、脑钠肽(BNP)。结果:与药物治疗组比较,CRT+药物治疗组明显增加患者的心脏输出量[(4.32±1.50)L/min:(3.41±1.00)L/min,P<0.05]及肱动脉内径的变化率(FMD)[(1 718±123)%:(976±118)%,P<0.05],FMD和心输出量呈正相关(r=0.6,P=0.003)。结论:CRT可以提高内皮细胞的功能,其机制可能是通过增加心输出量来实现的。Abstract: Objective:To explore the effect of cardiac resynchronization therapy（CRT） on vascular endothelial function in patients with congestive heart failure（CHF）. Method:CHF patients with dilated cardiomyopathy were divided into optimal drug group（n=10） and CRT+drug group（n=12）.Echocardiographic parameters,flow mediated diameter（FMD）,brain natriuretic peptide（BNP） were evaluated before therapy and 12 weeks after therapy started. Result:Compared with drug group,cardiac output（[4.32±1.50]L/min∶[3.41±1.00]L/min,P<0.05） and FMD（[1 718±123]%∶[976±118]%,P<0.05） were increased significantly in CRT+drug group.There was a positive correlation between FMD and cardiac output（r=0.6,P=0.003）. Conclusion:CRT could improve endothelial function by increasing cardiac output.
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