Pharmacotherapy For Heart Failure And Depicting The Left Ventricular Venous System With A Dynamic Volume Computed Tomography To Facilitate The Implant Procedure For CRT

Objective To investigate the effects of carvediol and candesartan combination on the level of n-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with congestive heart failure.Methods175patients were randomly divided into control group(accepted conventional treatment) and treatment group(medicine used in control group plus carvediol and candesartan for3months). NT-proBNP levels、LVEF(left ventricular ejection fraction)、FS (left ventricular fractional shortening) and CI (cardiac index) were evaluated before and after3months’therapy.Results After3months’therapy, the effectiveness rate was87.5%in treatment group and70.1%in control group (P<0.01); the values of LVEF、FS、 CI and NT-proBNP levels were improved in both groups; compared with the control group, the values of LVEF、FS、CI were improved significantly and the value of NT-proBNP level was much lower.Conclusion Standardized pharmacotherapy in patients with congestive heart failure may markedly decline NT-proBNP level for patients with CHF, improve cardiac function and reduce cardiovascular event rate. Objective To evaluate the value of320-slice dynamic volume computed tomography to depict the left ventricular (LV) venous system in order to facilitate the ilampntation of LV lead for cardiac resynchronization therapy (CRT).Methods The anatomy of the cardiac venous system was studied in110patients (40men; age57.9±10.8) in whom CT scanning was performed for noninvasive evaluation of coronary artery disease. Reconstructions were created from30to80%R-R intervals.Results The cardiac venous system was visualized in all subjects. For91.2%of the patients, the optimal phases of the cardiac cycle for the visualization were30to40%. For the most frequently used target veins in CRT, i.e. the posterolateral vein and the lateral vein, the percentage of one absent combined with narrowness in the other was23.6～26.4%; In5.5%of the subjects, none of the two veins was present.Conclusion The anatomy of the left ventricular venous system can be evaluated using320-slice dynamic volume CT. As substantial variation in anatomy was observed, its preimplantation visualization may help to facilitate the implant procedure for CRT.