プログラムされた心室刺激は,不律性右心室心筋病における追加的な主要な予防のリスク分層化ツールとして:多国間研究
Alessio Gasperetti1, Richard T Carrick1, Sarah Costa2
1Department of Medicine, Division of Cardiology, Johns Hopkins Hospital, Baltimore, MD (A.G., R.T.C., C. Tichnell, B.M., H.T., H.C., C.A.J.).
Circulation
|October 7, 2022
まとめ
プログラムされた心室刺激 (PVS) は,心室不律症 (ARVC) の患者の心室不律症 (VA) のリスク予測を改善します. PVSは,既存のリスク計算機を超えて,特に低リスクから中等リスクの個人にとって,重要な付加価値をもたらします.
科学分野:
- 心臓病科
- 電気生理学
- 遺伝学
背景:
- アリズム不全性右心筋症 (ARVC) は遺伝的な心疾患である.
- 静脈動脈不調 (VA) は,ARVC患者の主要なリスクである.
- ARVCにおける新しいリスク計算機は存在しますが,その限界は不明です.
研究 の 目的:
- プログラムされた心室刺激 (PVS) がARVC患者におけるVAリスクに対する追加の予後値を提供するかどうかを判断する.
- リスク計算機とPVSがVAを予測する際の性能を評価する.
- ARVCにおけるVAの第一予防におけるPVSの役割を評価する.
主な方法:
- 6つの国際登録から288人のARVC患者を遡及分析した.
- 患者は確固たるARVCの診断があり,以前の持続的なVAはなく,ベースラインはPVSでした.
- 継続的なVAに対する計算機によるリスクとPVS誘導性の評価 5年間の追跡調査
主要な成果:
- PVSは,患者の47. 6%で誘導性心室性短縮症を特定した.
- 持続したVAはPVS陽性患者の60. 6%とPVS陰性患者の24. 5%で発生した (P< 0. 001).
- PVSはVAの独立した予測因子であり,リスク予測の正確性を改善しました (C統計は0. 75対0. 72).
結論:
- プログラムされた心室刺激は,ARVC患者のVAリスクの階層化を著しく高めます.
- PVSは,既存のリスク計算機を超えて,予知的な付加価値を提供します.
- PVSは,低リスクから中等リスクのARVC患者のリスク評価を精密にするために特に有益です.
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