心脏再同步治疗后心脏功能短期变化的影响,对糖尿病或没有糖尿病的心力衰竭患者的长期预后的影响
Yu Yu1, Ligang Ding1, Hao Huang1
1State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Cardiac Arrhythmia Center, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Therapeutic advances in chronic disease
|January 22, 2024
概括
在CRT治疗后的短期心脏功能改善会影响心力衰竭的结果. 糖尿病改变了NT-proBNP,QRS持续时间变化和不良事件之间的联系,在糖尿病患者中显示出非线性影响.
科学领域:
- 心脏病学 心脏病学
- 心脏衰竭研究研究
- 医疗器械技术 医疗器械技术
背景情况:
- 对于接受心脏再同步治疗 (CRT) 的心力衰竭 (HF) 患者的短期心脏功能变化和长期结果存在不确定性,特别是当他们被糖尿病状态分层时.
- 了解这些关系对于优化CRT在不同患者群体中至关重要.
研究的目的:
- 评估CRT患者中心脏功能参数的短期变化与长期结果 (所有原因死亡率,HF住院) 之间的关联.
- 调查糖尿病状态是否会改变这些关联.
主要方法:
- 对666名接受CRT (2007-2019) 的高频患者进行了回顾性队列研究.
- 在基线和6个月评估心脏功能,包括LVEF,LVEDD,LAD,NT-proBNP和QRS持续时间.
- 主要终点:全因死亡率和HF住院治疗.
主要成果:
- 在糖尿病和非糖尿病患者中,LVEF,LVEDD和LAD的变化显示出类似的预后价值.
- 糖尿病显著改变了NT-proBNP/QRS持续时间变化和不良结果之间的关联.
- 在非糖尿病患者中,NT-proBNP和QRS持续时间的变化与死亡率和住院有积极的相关性;在糖尿病患者中,这种关系是非线性的.
结论:
- 在CRT后的短期心脏功能改善与长期风险的降低有关.
- 糖尿病影响NT-proBNP和CRT后QRS持续时间变化的预测值,需要量身定制的风险评估.
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