持续的长期心率变化和肺高血压风险评估
Mads Ørbæk Andersen1, Soren Zöga Diederichsen1, Jesper Hastrup Svendsen1,2
1Department of Cardiology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
Open heart
|June 29, 2023
概括
持续监测心率变化 (HRV) 和体力活动可以完善肺高血压 (PH) 风险评估. 较低的HRV预测更糟糕的预后,提供比目前的指导方针更好的风险分层.
科学领域:
- 心脏病学 心脏病学
- 肺部医学 肺部医学
- 生物医学工程 生物医学工程
背景情况:
- 目前的肺高血压 (PH) 风险评估依赖于欧洲心脏病学会/欧洲呼吸学会 (ESC/ERS) 的指南.
- 已确定的参数,如世卫组织功能类,6分钟步行测试和N-终端亲脑尿素提供预后见解,但反映了特定的时间点.
- 在PH管理中需要持续的风险分层方法.
研究的目的:
- 调查使用植入式循环记录器 (ILR) 进行持续监测的实用性,以改进PH风险评估.
- 分析ILR衍生的指标 (心率,心率变化,身体活动) 与已确定的ESC/ERS风险参数之间的关联.
- 为了确定是否持续监测标记可以预测PH患者的结果.
主要方法:
- 诊断为PH的患者被植入ILR以持续监测心率 (HR),心率变化 (HRV) 和身体活动.
- 来自ILR的数据被分析为与已建立的ESC/ERS风险参数的关联,使用相关性和混合效应模型.
- 用物流混合模型来评估HRV与1年死亡风险之间的关系.
主要成果:
- 在41名PH患者中,平均755天 (96个患者年) 进行了持续监测.
- 心率变化 (HRV) 和日间HR (PAiHR) 索引的体力活动显示出与ESC/ERS风险参数的显著关联.
- 较低的HRV与1年死亡风险的增加显著相关 (OR 0.82,p=0.027).
结论:
- 持续监测HRV和PAiHR提供了一种精细的方法来评估肺高血压风险.
- 这些持续监测的标记与已建立的ESC/ERS风险分层参数相关.
- 较低的心率变化是PH中预后较差的预测因素,从而改善了风险分层.
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