关键词:

心力衰竭, 老年, 心脏再同步化治疗, 应答反应, 影响因素

Abstract:

Objective　To analyze the factors influencing non-response to cardiac resynchronization therapy (CRT) in elderly patients with heart failure. Methods　A retrospective analysis was conducted on the clinical data of 80 elderly heart failure patients who underwent CRT between May 2020 and May 2023 at the Department of Cardiology, Xi'an Central Hospital, including 46 males and 34 females, 50 cases ≥80 years old and 30 cases <80 years old, cardiac function grade: 53 cases of grade III and 27 cases of grade IV. The patients were observed for CRT response and were categorized into the response and non-response groups. The clinical data were analyzed using univariate analysis, and variables with statistically significant differences were further analyzed using multivariate logistic regression analysis to analyze the influencing factors of non-response after CRT in elderly patients with heart failure. Independent sample t test and χ² test were used. Results　Among the 80 elderly patients who underwent CRT, 59 responded to the treatment, and 21 did not, resulting in a response rate of 73.75%. There were no statistically significant differences in the age, gender, body mass index, smoking history, drinking history, diabetes history, hypertension history, left atrial inner diameter (LAD), right ventricular inner diameter (RVD), triglyceride (TG) level, and cardiac function grade between the two groups (all P>0.05). There were statistically significant differences in the course of disease, mitral regurgitation volume, QRS wave duration, left ventricular ejection fraction (LVEF), and total cholesterol (TC) between the two groups (all P<0.05). Multivariate logistic regression analysis showed that the duration of disease ≥3 years, increased mitral regurgitation volume, reduced QRS wave duration, LVEF ≤30%, and elevated TC level were all risk factors for non-response to CRT in elderly patients with heart failure (all P<0.05). Conclusion　For elderly heart failure patients, risk assessment, electrophysiological evaluation, enhanced cardiac support, lipid management, and lifestyle interventions are essential to enhance the efficacy of CRT, reduce the non-response rate, and ultimately improve the patients' prognosis and quality of life.

Key words:

Heart failure, Elderly, Cardiac resynchronization therapy, Response, Influencing factors