延長されたQTc間隔と高レベルのB型ナトリウレチンペプチドは,進行した心不全患者の死亡率を予測します
Bojan Vrtovec1, Reynolds Delgado, Aly Zewail
1Heart Failure Center, Texas Heart Institute at St Luke's Episcopal Hospital, PO Box 20345, MC 2-114, Houston, Tex 77225-0345, USA.
Circulation
|April 1, 2003
まとめ
延長されたQTc間隔は,B型ナトリウレチンペプチド (BNP) 濃度が高い心不全患者の有害な結果の強力な予測因子です. この発見は,QTc延長が死亡リスクの増加の重要な指標であることを強調しています.
科学分野:
- 心臓病学 心臓病学
- 電気生理学 電気生理学
- 心不全に関する研究
背景:
- 心不全 (HF) でのQTc間隔延長の予後的意義は十分に確立されていません.
- 高濃度のB型ナトリウレチンペプチド (BNP) は,HF患者における重大な心臓のストレスを示している.
研究 の 目的:
- QTc間隔の持続時間と,BNPが上昇したHF患者におけるアウトカムとの関係を調査する.
- QTc延長が独立してこの患者コホートにおける死亡率を予測するかどうかを判断する.
主な方法:
- QTc間隔は,12リードのECGを使用して測定され,Bazettの式で修正され,BNP>400pg/mLの241人のHF患者で測定されました.
- 患者は延長QTc (>440 ms) と正常QTcのグループに分けられた.
- 死亡,移植,左心室補助器官 (LVAD) 植入などのアウトカムが6ヶ月間追跡されました.
主要な成果:
- 患者の51%がQTc間隔を長引いた;BNPレベルはグループによって有意に違わなかった.
- 延長QTc群は,通常のQTc群 (P<0.0001) に比べて3倍高い死亡率を経験しました.
- 多変量分析により,長時間のQTcは,全因死亡,心臓死,突然心臓死,ポンプ不全による死亡の独立した予測因子であると確認されました.
結論:
- 延長されたQTc間隔は,BNPが上昇した心不全患者の有害な結果の有意な独立した予測因子です.
- QTc延長は,この高リスク集団における重要な予後マーカーとして機能します.
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