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[ESC2011]心衰患者CRT(心脏再同步化治疗)研究进展——ESC2011新当选主席Vardas教授专访

作者:  Vardas   日期:2011/9/1 17:49:28

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《国际循环》:CRT“无反应患者”的预测因子一直是CRT研究的热点。到目前为止,无论是超声还是心电学指标,没有一个指标被证明能够用于预测。您能否谈谈在这个问题上的进展?如果没有办法发现单个有预测价值的指标,是否能够设定一个由多种指标构成的评分系统?

P E Vardas  ESC2011新当选主席

    <International Circulation>: Predictor of CRT “nonresponders” is always a hot topic in the field of CRT. Until now no parameters were proved to be available, no matter ultrasonic or cardioelectronic. Could you talk about any new findings in this issue? If we could not find a single factor with high predictive value for nonresponders, could we set a score consisting of several independent factors? 

   《国际循环》:CRT“无反应患者”的预测因子一直是CRT研究的热点。到目前为止,无论是超声还是心电学指标,没有一个指标被证明能够用于预测。您能否谈谈在这个问题上的进展?如果没有办法发现单个有预测价值的指标,是否能够设定一个由多种指标构成的评分系统?

    Prof Vardas: Indeed, at the moment we do not have a universal parameter which can detect 100% of non-responders and furthermore we have not been able to devise a score in predicting these non-responding patients. However, we have to be aware of a very important issue that is that we should select patients very carefully for CRT before we pay attention to the non-responders. According to the guidelines, we have to fufill certain characteristics for these patients in order to include them in this therapy. One criterion is judged by the electrocardiogram and secondly you have to realize that a lot of the implanters are not very expereinced to ensure optimal results for the patient. During, implantation you have to select the optimal veins and sometimes this is not the case in some centres. In terms of new developments in detecting non-responders, there has not been anything strikingly new. However, using ECHO criteria, we have a better expereince in differentiating between the responders and non-responders. I know that in the scientific community, there has been talk about a possible predicive score, but as of yet nothing has been confirmed and tested at the moment.

    Vardas教授:事实上,目前我们没有一个万能的参数能够100%检测出无反应者,此外,我们一直无法设计出一个评分系统来预测无反应的患者。但是,我们必须意识到一个非常重要的问题即在我们关注无反应者之前,应该非常谨慎地选择植入CRT的患者。根据指南,我们不得不对这些患者实施特定的准则以便他们进行CRT治疗。一个准则就是判断心电图,其次,你不得不意识到许多术者在确保患者的最佳结果方面并不十分有经验。植入术中,你必须选择最佳静脉,有时候在某些中心比不是这种情况。在检测无应答者的新进展方面,没有什么新的惊人的发现。然而,使用EHO标准,我们在区分有反应和无反应者方面有更好的经验。我知道在科学界,人们一直讨论可能的预测评分系统,但是目前其尚未被证实并且获得检验。

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