在重症患者中,预测新出现的前庭动负担的预测因素
Daniel Lancini1,2, Jennifer Sun1, Georgia Mylonas1
1Cardiology Department, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
Cardiology
|October 8, 2023
概括
在关键疾病相关的新发性心房 (CI-NOAF) 中确定了心房 (AF) 负担的预测因素. 较大的左心房区域和慢性病增加了AF负担,而β阻塞剂减少了它.
科学领域:
- 心脏病学 心脏病学
- 关键护理医学 关键护理医学
- 电力生理学 电力生理学
背景情况:
- 前庭动 (AF) 在重症监护室 (ICU) 普遍存在,并与不良结果有关.
- 了解AF负担预测因子对于管理关键疾病相关的新发性AF (CI-NOAF) 至关重要.
- 目前关于AF病理生理学和ICU环境中的驱动因素的知识是有限的.
研究的目的:
- 为了确定CI-NOAF患者中AF负担的预测因素.
- 调查临床,实验室和心声学参数与AF负担之间的关联.
- 为了区分严重疾病中AF负担的驱动因素.
主要方法:
- 对7030名ICU入院者的回顾性分析,确定了309名CI-NOAF患者.
- AF负担通过连续心电图量化为AF监测时间的百分比.
- 多变量后勤回归用于识别AF负担的独立预测因素.
主要成果:
- 中位数AF负担为7.0%.
- 与老年相关的AF负担增加,脂质不良,慢性病,较高的肌素,CHA2DS2-VASc得分,特定的ICU诊断,阿米奥达龙使用和较大的左心房区域 (LAA).
- 较低的AF负担与先前的酒精过量,通风持续时间,因诺托普/血管压缩剂使用和β阻塞剂使用有关. 增加AF负担的独立预测因素是LAA,CKD和阿米奥达龙;β阻断剂降低了负担.
结论:
- 左心房大小和慢性心血管并发症是CI-NOAF负担的主要驱动因素.
- 急性疾病因素和重症监护干预并没有显著地推动心律失常负担.
- 需要进一步研究AF驱动因素和重症患者的节律控制疗效.
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