无症状或有症状的心房动:心力衰竭患者的临床结果
Giuseppe Boriani1, Niccolo' Bonini2, Marco Vitolo2
1Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Via del Pozzo, 71, Modena 41124, Italy.
European journal of internal medicine
|September 27, 2023
概括
无症状心房动 (AF) 具有较高的不良结果风险,特别是在心力衰竭 (HF) 和左心室喷射率 (LVEF) 减少的患者中. 这凸显了在HF管理中考虑AF症状状态的重要性.
科学领域:
- 心脏病学 心脏病学
- 临床医学 临床医学
- 流行病学 流行病学
背景情况:
- 前庭动 (AF) 的管理需要了解不同患者亚组的结果.
- 在心力衰竭 (HF) 和左心室喷射率 (LVEF) 变化的患者中,无症状与症状AF的预后影响仍然不清楚.
研究的目的:
- 为了澄清无症状和症状的AF患者之间的结果差异,根据HF和LVEF状态分层分层.
- 在特定的HF和LVEF亚组中调查无症状AF与不良事件的独立关联.
主要方法:
- 一项前性观察研究,包括8096名AF患者.
- 根据明显的HF存在和LVEF (≤40%或>40%) 患者被分为8组.
- 对复合结局 (全因死亡,MACE) 的随访和无症状与症状AF影响的分析.
主要成果:
- 在整个队列中,无症状和症状AF之间的复合结果没有显著差异.
- 与同一组的症状性AF患者相比,无症状AF患者的HF和LVEF≤40%显示出明显较差的结局 (综合结局和全因死亡).
- 调整后的分析显示无症状的AF与HF和LVEF≤40%作为一个独立的预测器,对复合结果和所有原因死亡的风险更高.
结论:
- 在一个大规模的欧洲AF队列中,无症状AF与症状AF相比,没有增加整体2年复合结局风险.
- 然而,无症状的AF与心力衰竭和左心室射出分数减少 (LVEF ≤40%) 的患者的不良结果有关.
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