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在心力衰竭中对心房动进行节律控制后,左心室喷射小部分的轨迹变化

Jinping Si¹, Yuxi Sun², Lin Bai¹

¹Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China.

ESC heart failure

|December 14, 2023

概括

节律控制疗法显著改善左心室喷射率 (LVEF) 轨迹在心房动 (AF) 和心力衰竭 (HF) 的患者. 这一策略还减少了死亡率和住院率,这表明它是最佳的治疗选择.

科学领域:

心脏病学心脏病学
电子生理学电子生理学
心脏衰竭管理的管理

背景情况:

心房动 (AF) 和心力衰竭 (HF) 经常同时存在,影响患者的预后.
节律控制疗法在AF和HF中具有好处,但其对整个HF频谱的左心室喷射率 (LVEF) 轨迹的影响还未得到充分研究.

研究的目的:

调查AF和HF患者中LVEF轨迹变化的患病率和预测因素.
探索节律控制治疗后LVEF轨迹变化的预后影响.
为了比较节奏和速度控制策略之间的LVEF轨迹改进.

主要方法:

一项匹配的队列研究比较了AF和HF患者的节律控制和节奏控制策略.
分析LVEF轨迹的变化,全因死亡率和与HF相关的入院病例.
使用考克斯回归和生存分析来确定结果和预测因素.

主要成果:

节律控制组显示LVEF轨迹改善的百分比明显更高 (53.3%对39.4%,P=0.012).
节律控制与改善LVEF轨迹的可能性更高 (HR 1.671,P=0.003).
节律控制组的患者具有明显较低的全因死亡风险 (HR 0.600,P=0.043) 和与高频率相关的入院风险 (HR 0.611,P<0.001).

结论:

节律控制疗法与增强的LVEF轨迹和同时患有HF和AF的患者的改善临床结果有关.
研究结果表明,节律控制可能是这种患者群体首选的治疗策略.
在节律控制小组中,LVEF改善的独立预测因素包括下部E/e,左心室末端透气直径和CHA2DS2-VASc得分.

关键词:

心房动是一种心房动.心脏衰竭是因为心脏衰竭.左心室喷射分数的部分.节奏控制控制节奏控制节奏控制节奏飞行轨迹的轨迹是可以的.

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