延长的QTc间隔和高的B型尿素水平共同预测了晚期心力衰竭患者的死亡率
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
概括
延长的QTc间隔是心力衰竭患者高B型尿素 (BNP) 水平的不良结果的强有力的预测因素. 这一发现强调了QTc延长作为增加死亡风险的关键指标.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 心脏衰竭研究研究
背景情况:
- 在心力衰竭 (HF) 中QTc间隔延长的预后意义尚未得到充分确立.
- 高的B型尿素 (BNP) 水平表明HF患者的显著心脏应变.
研究的目的:
- 为了研究QTc间隔持续时间和HF患者高BNP的结果之间的关系.
- 确定QTc延长是否独立预测该患者队列中的死亡率.
主要方法:
- 在241名HF患者中,使用12导电图测量QTc间隔,并使用Bazett的公式进行校正,BNP>400 pg/mL.
- 患者被分为延长的QTc (>440毫秒) 和正常的QTc组.
- 包括死亡,移植和左心室辅助装置 (LVAD) 植入在内的结果在6个月内被跟踪.
主要成果:
- 51%的患者有延长的QTc间隔;在不同组之间,BNP水平没有显著差异.
- 与正常QTc组相比,延长QTc组的死亡率是正常QTc组的3倍 (P<0.0001).
- 多变量分析证实,延长QTc是所有原因死亡,心脏死亡,突然心脏死亡和失败死亡的独立预测因素.
结论:
- 延长的QTc间隔是心力衰竭患者高BNP的不良结果的显著独立预测因素.
- 在这种高风险人群中,QTc延长作为关键的预后标志物.
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