在初级预防性植入式心脏转换器-除器治疗后的长期预后和预后因素
Masafumi Sugawara1, Yusuke Kondo1, Satoko Ryuzaki1
1Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba, Japan.
Journal of cardiology
|February 21, 2024
概括
非持续性心室低心率 (NSVT) 在接受预防性植入式心脏转换器-除器 (ICD) 患者的心力衰竭中没有预测主要不良心脏事件 (MACE). 然而,心房动与这些患者的预后更差有关.
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:
- 在初级皮肤间干预时代,对缺血性心肌病 (ICM) 患者的预防性治疗选择的理解有限.
- 需要评估非持续性心室低心率 (NSVT) 在预测心力衰竭的不良结果中的作用,减少喷射率 (HFrEF) 患者.
研究的目的:
- 研究NSVT对ICM的HFrEF患者主要心脏不良事件 (MACE) 的影响.
- 在接受初级预防性植入式心脏转换器-除器 (ICD) 植入的患者中确定MACE的预测因子.
主要方法:
- 在2006年10月至2020年8月期间接受ICD植入的ICM和非ICM患者的回顾性分析.
- MACE被定义为心血管死亡,心力衰竭住院治疗和适当的ICD治疗的复合物.
- 多变量考克斯分析以确定MACE的独立预测因子.
主要成果:
- 167名患者被纳入; 74%的人有NSVT,34%的人有ICM.
- 在平均61个月的随访期间,MACE发生在43%的患者身上.
- 前庭动 (HR 2.00; p=0.01) 是MACE的独立预测因子,而NSVT则不是.
结论:
- 之前的NSVT不是HFrEF患者与初级预防性ICD的未来MACE的独立预测因素.
- 在这组患者中,心房动与更糟糕的预后有关.
- 包括心房动在内的全面风险分层对于预测MACE在初级预防性ICD患者中至关重要.
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