对布鲁加达综合征风险分层的编程腹腔刺激:综合分析
Jakub Sroubek1, Vincent Probst1, Andrea Mazzanti1
1From Division of Cardiology, Beth Israel Deaconess Medical Center, Boston, MA (J.S.); Service de Cardiologue du CHU de Nantes, CHU de Nantes, Hôpital Nord, Nantes, France (V.P.); Molecular Cardiology, IRCCS Fondazione Salvatore Maugeri, Pavia, Italy (A.M., C.N., S.G.P.); Dipartimento di Medicina, Molecolare Università di Pavia, Pavia, Italy (S.G.P.); Division of Cardiology, Casa di Cura Pederzoli, Peschiera del Garda, Verona, Italy (P.D.); Arrhythmia Unit, Cardiovascular Surgery and Cardiology Institute, Havana, Cuba (J.C.H.); Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan (K.O., I.W.); Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy (A.Z., D.C.); Institut Universitaire de Cardiologie et Pneumologie de Québec, Quebec City, QC, Canada (J.C., I.N.); Department of Electrophysiology and Pacing, Onassis Cardiac Surgery Center, Athens, Greece (A.K., G.T.); Boston University and National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA (X.Y.); Cardiovascular Research Center and Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston (D.J.M., P.T.E., S.A.L.); Heart Centre AMC, Department of Clinical and Experimental Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands (A.W.); Princess Al-Jawhara Al-Brahim Centre of Excellence in Research of Hereditary Disorders, Jeddah, Kingdom of Saudi Arabia (A.W.); Bordeaux University Hospital, LIRYC Institute/INSERM 1045, Bordeaux, France (F.S.); First Department of Medicine-Cardiology, University Medical Centre Mannheim, Mannheim, Germany (M.B.); DZHK (German Centre for Cardiovascular Research), partner site Heidelberg/Mannheim, Mannheim, Germany (M.B.); Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA (P.T.E., S.A.L.); Department of Cardiology, General Hospital of Conegliano, Conegliano, Treviso, Italy (G.A.); and Lankenau I
编程腹腔刺激可以识别高风险突发死亡的布鲁加达综合征患者. 引起心律失常,尤其是在刺激较少的情况下,表明风险增加,但临床因素仍然至关重要.
科学领域:
- 心脏病学
- 电生理学
- 遗传学
背景情况:
- 布鲁加达综合征是一种与心脏突然死亡风险增加相关的遗传疾病.
- 编程腹腔刺激 (PVS) 在布鲁加达综合征风险分层中的有用性仍在争论中.
研究的目的:
- 系统评估PVS在识别高风险突发心脏事件的布鲁加达综合征患者中的作用.
- 分析PVS引起的心律失常和随后的心脏事件之间的关联.
主要方法:
- 对前性观察性研究进行系统审查和综合分析.
- 包括1312名没有先前心脏骤停的布鲁加达综合征患者,他们接受了PVS.
- 分析个人数据以估计心脏骤停或ICD冲击的发病率和风险.
主要成果:
- 在PVS期间诱导心律失常与心脏事件的风险增加2. 66倍有关.
- 用较少的外刺激 (单次或双重) 诱导产生最高风险.
- 根据病史,自发型1型心电图和心律失常诱导,每年发生病例的发生率有显著差异.
结论:
- 在布鲁加达综合征中,PVS诱导的心律失常是未来心室失常风险的重要预测因素.
- 诱导所需的外刺激数量与风险相关,较少的外刺激数量更危险.
- 临床风险因素至关重要;没有诱导并不能保证低风险,特别是在高风险患者中.
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