<International Circulation>: HF patients with NYHA (New York Heart Association) class Ⅱ were recommended to accept CRT based on several clinical trails such as the RAFT study. But there were some different voices that there may be an overuse of CRT according to the guidelines. What’s your opinion about CRT therapy in patients with mild heart failure symptoms?  

   《国际循环》：基于大量的临床研究，例如RAFT研究的结果，目前的指南推荐NYHA心功能Ⅱ级的心衰患者可接受CRT治疗。但目前仍有不同的观点，认为按照指南推荐会造成CRT的过度使用。您对于轻度心衰患者接受CRT治疗是怎么看的？

    Prof Vardas: The trial in question enrolled 1798 New York Class 2 or 3 heart failure patients. I would like to remind you that 20% of these patients had New York Association class 3 heart failure. It is important to emphasize that mortality in this trial was reduced by 25% because of CRT. In addition the risk of the primary endpoint was signoificantly reduced by 25% from 40%. This alone indicates that this was an encouraging trial for patients who even with class 2 to receive CRT; of course we have to look at other parameters. After all we are talking about patients with broad QRS; we should look at how symptomatic the patients are in specific areas and how much the mechanical dysynscrony is. In general the results of RAFT were encouraging.

    Vardas教授:我们谈论的这项试验入选了1798名纽约心功能分级在II-III级的患者。我想提醒你的是20%的入选患者有纽约心功能分级III级的心力衰竭。需要着重强调的是，在本试验中，由于CRT死亡率降低了25%。仅此一点就表明，对于接受CRT的患者甚至心功能分级II级的患者来说，这是一个鼓舞人心的试验；当然我们还必须考虑其他参数，毕竟我们谈论的是宽QRS患者；我们应该看一下在特定位置这些患者的症状如何，机械收缩不同步的程度怎么样。总之，RAFT的研究结果是令人鼓舞的。