静脈応答の不規則性の低下は,慢性心房細動の患者における死亡率の増加と関連しています
1Third Department of Internal Medicine, Nagoya City University Medical School, Nagoya, Japan. a.yamada@med.nagoya-cu.ac.jp
Circulation
|July 19, 2000
まとめ
心房細動 (AF) の間に心室応答間隔 (VRI) の不規則性が減少すると,心臓死が予測されます. 下のVRI不規則性は,AF患者の死亡リスクが高いことを示し,その予後値を強調しています.
科学分野:
- 心臓病学 心臓病学
- バイオメディカルエンジニアリング
- 臨床電気生理学 臨床電気生理学
背景:
- 心房細動 (AF) の Ventricular Response Interval (VRI) 変動は,有害な結果と関連している可能性があります.
- AFにおけるVRIダイナミクスの予測的意義は不明である.
研究 の 目的:
- 慢性AFの患者の臨床結果に対するVRIの変動と不規則性の予後値を調べる.
主な方法:
- 慢性AF患者107人の24時間の外来心電図を分析した.
- 評価されたVRIの変動性 (SD,連続差のSD,5分平均のSD) と不規則性 (シャノンエントロピー,シンボリックダイナミクス,近似エントロピー[ApEn(b-b),ApEn(m-m) ]).
- 33ヶ月の追跡期間における心臓死,致死性脳卒中,全因死亡率と相関するVRI測定値.
主要な成果:
- 減少したVRIの変動と不規則性の測定は,心臓死のリスクの増加と相関しています.
- VRIの不規則性測定 (シャノンエントロピー,ApEn) は,エジェクション分数と不全性AFを調整した後に独立して心臓死亡率を予測した.
- 下のApEn (b-b) 値は,5年後の心臓死亡率の有意なグラデーションを示した (0%対13%対43%).
結論:
- 24時間EKGにおけるVRI不規則性の減少は,慢性AFにおける心臓死亡率の独立した予測因子である.
- VRI不規則性分析は,AF患者の管理のために貴重な予後情報を提供します.
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