心率预测了可植入心脏转换器-除器人群的结果
Mastaneh Ahmadi-Kashani1, David J Kessler, John Day
1Department of Medicine, University of Iowa Hospitals, 4426a JCP, 200 Hawkins Dr, Iowa City, IA 52242, USA.
Circulation
|November 11, 2009
概括
心率升高 (HR) 与植入式心脏转换器-除器 (ICD) 患者的结果更差有关. 较高的平均HR独立预测死亡或心力衰竭住院的风险增加,强调HR是关键的预后因素.
科学领域:
- 心脏病学 心脏病学
- 电力生理学 电力生理学
- 临床试验 临床试验
背景情况:
- 心率升高 (HR) 是已知的心血管不良事件和一般人群和心脏病患者死亡率的风险因素.
- 平均HR作为接受植入式心脏转换器-除器 (ICD) 患者的预测结果的作用需要进一步调查.
研究的目的:
- 为了研究平均HR预测ICD植入患者的总死亡率和心力衰竭住院治疗的假设.
- 为了确定内在心率的预后意义在患有ICD的患者.
主要方法:
- 从ICD (INTRINSIC RV) 试验中抑制不必要的RV加速度与AV搜索歇斯底里症的数据分析,包括1530名患者植入双室ICD.
- 平均HR是从设备组图中确定的,对1436名患者的平均随访时间为10.4个月.
- 使用曼特尔-汉泽尔顺序性测试和考克斯回归来评估平均HR与主要终点 (死亡或心力衰竭住院) 之间的关系的统计分析.
主要成果:
- 较高的内在 (无节奏) HR与死亡或心力衰竭住院的风险增加显著相关 (P<0.001).
- 平均HR>90bpm的患者与平均HR<75bpm的患者相比,患初级终点的风险增加了3.6倍.
- 在多变量分析中,HR是独立的显著预测因子 (危险比1.34,P=0.0001),以及年龄,NYHA类和RV节奏.
结论:
- 平均内在HR是ICD患者不良结果的强有力的独立预测指标.
- 平均HR应被认为是治疗ICD患者的重要预后标志物.
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