结果与左束分支块的T波异调以及保存或轻微减少的喷射分数
Hui-Chun Huang1, Kuo-Liong Chien1,2, Yen-Bin Liu1
1Department of Internal Medicine, Division of Cardiology, National Taiwan University Hospital and National Taiwan University College of Medicine, National Taiwan University, No. 7 Chung-Shan South Rd, Taipei, 100, Taiwan.
患有左束分支阻塞 (LBBB) 和保存的喷射分数 (EF) 的患者的T波异调预测不良心血管事件. 这一发现有助于对患有LBBB的心力衰竭患者的风险分层.
科学领域:
- 心脏病学 心脏病学
- 电心电图是指心电图.
- 心脏衰竭研究研究
背景情况:
- 左捆支部阻塞 (LBBB) 与心力衰竭患者的不良结果有关.
- 在患有保留喷射分数 (EF) 的患者中,LBBB的预后意义尚未得到充分确立.
- T波异调是LBBB.风险分层的一个潜在标志物.
研究的目的:
- 评估T波异调对LBBB患者和保存或轻微减少EF的预后的预测值.
- 为了确定T波形态 (不一致与一致) 是否会影响心血管结果.
- 在这个患者群体中确定不良事件的独立预测因子.
主要方法:
- 从2010年至2018年对707名LBBB和LVEF≥40%的患者进行了分析.
- 在串行心电图上将T波模式分类为不一致的LBBB (dLBBB) 或一致的LBBB (cLBBB).
- 多变量考克斯回归以确定复合心血管死亡或心力衰竭住院治疗的预测因素.
主要成果:
- 与cLBBB相比,dLBBB患者表现出更多的并发症和更糟糕的LV重塑.
- 不良结果的独立预测因素包括年龄,心力衰竭史,CKD,较大的LV末缩体积,较低的LVEF和dLBBB.
- dLBBB与心血管死亡或心力衰竭住院的风险增加1.63倍相关 (HR=1.63,P=0.032).
结论:
- 在LBBB中T波异调是保留EF患者心血管不良结果的独立预测因素.
- dLBBB识别了心血管死亡或心力衰竭住院住院风险较高的患者.
- 电脑心电图T波形态学在LBBB患者中提供了有价值的预后信息,具有保存的EF.
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