流動性および非流動性心房動の患者における左心房低圧の流行と複数の予測要因: 系統的レビューとメタ解析
Carlo-Agostino Oliva1,2,3, Matteo Morello1,4,5, Jordana Kron6
1Unità Operativa di Cardiologia, Ospedale di Circolo, ASST Settelaghi, 21100 Varese, Italy.
まとめ
心房細動患者における低電圧領域は心房筋症に関連しています. 予測因子には,年齢,CHA2DS2-VAScスコア,非パロキシズマ AFがあり,AFのタイプによって性別とBMIが異なる.
科学分野:
- 心臓病科
- 電気生理学
- アトリアル心筋病の研究
背景:
- 左心房 (LA) の低電圧領域 (LVAs) は,心房細動 (AF) の患者における心房筋症 (AtCM) の指標である.
- LVAの流行と予測要因を理解することは,AFとその基礎となる基質の管理に不可欠です.
研究 の 目的:
- カテーテル切除を受けたAF患者の大群におけるLVAの有病率と予測要因を評価するメタアナリシスを行う.
- LVAの存在に関連した主要な臨床的,エコーカルディオグラフィック,およびバイオマーカー要因を特定する.
主な方法:
- LA切除を受けた患者5278人を対象とした22件の研究を含めた.
- メタアナリシスは,LVAsの流行を決定し,さまざまな予測因子に対するオッズ比率 (ORs) を計算します.
- 副群とメタ・リグレッション分析で,AF型およびその他の要因に基づく予測値の変動を調査する.
主要な成果:
- LVAはパロキシズマ AF患者の28%と非パロキシズマ AF患者の41%で発見されました.
- 最も強い予測因子には,高齢者 (> 65歳),高いCHA2DS2- VAScスコア,非パロキシズマ AF,高いNT- プロBNP,女性の性別,増加したE/ e'比率,減少したeGFR,およびより大きなインデックスLA量が含まれています.
- 女性の性別,LA直径,BMIの予測値は,パロキシズマ的および非パロキシズマ的AFの間で異なっていた.
結論:
- LVAsは,パロキシズマ的および非パロキシズマ的AFの両方で流行しており,さまざまな変数によって予測できます.
- AFサブタイプによって影響が異なるため,AF患者の臨床管理戦略ではこれらの予測要因を考慮する必要があります.
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