International Circulation: Do you feel that smoking is still a very large problem in Europe?
　　《国际循环》：你认为吸烟在欧洲仍然是一个非常大的问题吗？
　　Prof Komajda: Yes it is. But the advantage we have over China and in fact in many countries， public smoking has been banned which has reduced smoking in the overall population except in the younger generation. This is really a worry for us because we anticipate a new rise in cardiovascular disease when these young people reach forty or fifty years of age.
　　Komajda教授：是的。但我们（实际上是在许多国家）超过中国的优势在于公共场所吸烟已被禁止，这减少了总人群的吸烟，除了在年轻一代中。这对我们来说的确是一件令人担忧的事情，因为我们预计，当这些年轻人到了四、五十岁的年龄时，心血管疾病会出血新的升高。
　　International Circulation: The guidelines on device therapy have been updated such that CRT is now indicated for NYHA Class II patients as opposed to just Class III and IV. Some have raised objections to this saying that the MADIT-CRT data showed a decrease in hospitalizations but not really a decrease in death rate. What is your opinion on this?
　　《国际循环》：装置治疗指南已经更新，CRT现在适用于NYHA II级的患者，而不是只是III级和IV级。有些人对此提出了反对意见，称MADIT- CRT数据显示住院减少但不是真正的死亡率下降。你对此有何看法？
　　Prof Komajda: I think this is correct that there are other studies and one European study in particular which was performed in the United States and Europe on patients with mild to moderate heart failure with wide QRS. These patients were implanted with a CRT which was either on or off and obviously there was a reverse remodeling and here again a reduction in heart failure hospitalizations in these mild heart failure patients. So I am really convinced that the expansion of the indications to mild to moderate heart failure patients with wide QRS (because at the moment we have no indication that this procedure is beneficial in narrow QRS) should be considered.
　　Komajda教授：我认为这是正确的，有其他的研究，以及尤其是一项在美国和欧洲开展、有关宽QRS波的轻至中度心力衰竭患者的欧洲研究。这些患者被植入打开或关闭的CRT，在这些轻度心力衰竭的患者中，显然存在逆向重构，且再次发现有心力衰竭住院的减少。因此我确信应当考虑将适应证扩大到宽QRS波的轻度至中度心力衰竭的患者，因为目前我们尚无任何迹象表明该手术在窄QRS波中有益。

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