心率:成人先天性心脏病的可访问风险指标
Paul M Hendriks1, Annemien E van den Bosch1, Jan A Kors2
1Department of Cardiology, Erasmus MC, Cardiovascular Institute, Thorax Center, Rotterdam, Netherlands.
Heart (British Cardiac Society)
|November 23, 2023
概括
更高的静止心率与患有先天性心脏病 (ACHD) 的成年人更糟糕的结果有关. 这项研究发现,在ACHD患者中,心率较高的心力衰竭患者的死亡率和心力衰竭风险增加.
科学领域:
- 心脏病学 心脏病学
- 成人先天性心脏病 (ACHD) 研究研究
背景情况:
- 休息时心率升高是一般和心血管患者不良结果的已知危险因素.
- 休息心率在成人先天性心脏病 (ACHD) 的预后意义需要进一步调查.
研究的目的:
- 评估在中度或复杂的心脏病发作症患者的静止心率和不良结果之间的关联.
主要方法:
- 一项前性观察队列研究,包括556名ACHD患者.
- 通过模块化心电图分析系统 (MEANS) 确定心率,使用休息的12导电图来确定心率.
- 主要终点:全因死亡率;次要终点:死亡率和心力衰竭的组合. 生存分析使用了卡普兰-梅尔和考克斯的比例危险模型.
主要成果:
- 总共包括556名患者 (平均年龄32岁),平均心率为69±13次/小时.
- 在平均10.1年的随访期间,6.5%的患者死亡,14.9%的患者达到二级终点.
- 较高的心率与较低的存活率和无心力衰竭的存活率显著相关,即使经过对临床因素的调整 (死亡率HR 1.57每10 bpm;死亡率/HF HR 1.33每10 bpm).
结论:
- 休息心率是ACHD患者死亡率和心力衰竭的重要独立预测因素.
- 心率升高可以识别出在 ACHD 群体中风险较高的个体.
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