左轴偏差与心脏不良事件在右心室节拍中的出现之间的关系
Naoya Inoue1, Takashi Ogane2, Takehiro Hiramatsu1
1Department of Cardiology, Chutoen General Medical Center, Kakegawa, Shizuoka, Japan; Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
Journal of electrocardiology
|June 16, 2023
概括
与正常轴相比,右心室节拍期间左轴偏差不会增加心脏不良事件的风险,如心房动或心力衰竭. 这一发现对于理解与节奏相关的心脏风险至关重要.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
背景情况:
- 右心室节奏 (RVP) 可以改变电轴,导致正常轴或左轴偏差 (LAD).
- 在RVP之后LAD的临床意义,特别是它对心脏不良事件的影响,仍然不清楚.
研究的目的:
- 为了调查右心室节拍 (RVP) 后的左轴偏差 (LAD) 是否与正常电轴相比,与心脏不良事件的发生率更高有关.
主要方法:
- 分析了接受RVP的156名患者的队列.
- 患者被分为两组:LAD组 (n=77) 和正常轴 (NA) 组 (n=79).
- 主要综合结局包括新发性心房动 (AF) 和恶化的心力衰竭 (HF),随访时间中位数为1100天.
主要成果:
- 在各组之间,QRS轴有显著的差异 (LAD:-64.5 ± 14.3°,NA: 29.8 ± 36.5°,P < 0.001).
- 主要复合结局的发生率相似:LAD组的37.6%,NA组的35.4% (HR,1.03;P=0.89).
- 具体结果也没有显著差异:AF (HR,1.07;P=0.77) 和恶化HF (HR,0.65;P=0.35).
结论:
- 在RVP之后的左轴偏差不会增加心脏不良事件的风险,包括新发的AF或恶化的HF.
- 该研究表明,与正常轴相比,在RVP的背景下,LAD与心血管死亡率,心肌梗塞,中风或整体死亡率的增加无关.
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