在具有结构正常的心脏的年轻成年人中长期右心室节奏的作用
Sandeep Sagar1, Win-Kuang Shen, Samuel J Asirvatham
1Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minn., USA.
Circulation
|April 7, 2010
概括
在患有先天性心房阻塞的患者中,右心室节奏可以导致心力衰竭. 那些具有抗核抗体 (Ab(+)) 的人面临着更高的风险,而不是那些没有 (Ab(-)).
科学领域:
- 心脏病学 心脏病学
- 免疫学 免疫学 免疫学
- 遗传学 是一个遗传学.
背景情况:
- 右心室节奏 (RVP) 与结构性心脏病患者的心力衰竭有关.
- 在没有结构性心脏病的人群中,RVP的长期影响尚未完全理解,可能涉及与潜在疾病的相互作用.
- 先天性心房阻塞 (CAVB) 是一种独特的模型,可以在没有结构性心脏病的情况下研究RVP效应.
研究的目的:
- 调查RVP对CAVB.成人心脏功能和生存的长期影响.
- 确定抗核抗体 (ANA) 的存在是否会影响这些患者心力衰竭和死亡率的发展.
- 评估免疫因素在与RVP相关的心脏功能障碍中的作用.
主要方法:
- 在1964年至2005年期间接受心脏起器的103名CAVB患者的回顾性分析.
- 在ANA阳性 (Ab(+)) 和ANA阴性 (Ab(-)) 患者之间比较结果 (心力衰竭,存活率,左心室喷射率).
- 来自明尼苏达州奥姆斯特德县的匹配人口控制被用于比较.
主要成果:
- 与匹配的人群相比,在整体CAVB队列中,无心力衰竭的长期存活率明显较差.
- 67%的Ab(+) 患者患有心力衰竭,比Ab(-) 患者 (2%) 和一般人群 (2%) 的患病率高得多.
- 左心室喷射分数在Ab(+) 患者显著下降,但在Ab(-) 患者保持稳定.
结论:
- 需要节奏的CAVB患者的长期预后受到ANA状态的显著影响.
- ANA阳性是心力衰竭发展的预测指标,并且在接受RVP的CAVB患者中增加了死亡率.
- 单独使用RVP似乎不会导致心力衰竭,心室功能障碍或在ANA阴性CAVB患者的生存率降低.
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