激活率-响应与心脏器械携带者急性心力衰竭的死亡风险增加有关
Moritz T Huttelmaier1, Sascha Münsterer1,2, Caroline Morbach1,2
1Dept. of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany.
PloS one
|April 18, 2024
概括
在急性不补偿性心力衰竭 (AHF) 期间,心脏植入式电子设备 (CIED) 患者的激活R模式刺激与12个月死亡风险更高有关. 这表明R模式可能无法充分解决AHF的慢性无能.
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:
- 由于急性不补偿性心力衰竭 (AHF) 住院的心脏植入式电子设备 (CIED) 的患者可能有不同的设备设置.
- R模式刺激,一种自动节奏模式,是调整心率根据活动的设置之一.
研究的目的:
- 研究CIED患者激活R模式刺激与AHF住院期间和之后的预后之间的关联.
- 确定R模式激活是否影响AHF患者12个月全因死亡率.
主要方法:
- 一项前性队列研究包括了623名因AHF入院的患者.
- 患者被分为三个组:具有激活R模式的CIED (CIED-R),没有R模式的CIED (CIED-0) 和没有CIED.
- 考克斯比例危险回归被用来分析R模式对12个月死亡率的独立影响,调整为混因素.
主要成果:
- 与CIED-0 (80 bpm) 和非CIED (82 bpm) 组相比,CIED-R组 (n=37) 的平均入院心率 (70 bpm) 较低 (p<0.001).
- 医院住院死亡率在各组中相似.
- 在多变量调整后,激活R模式独立地与12个月全因死亡风险显著增加相关 (HR 2.44-2.61).
结论:
- 在CIED患者中,R模式刺激与AHF住院患者的R模式刺激与12个月死亡风险大幅增加有关.
- 入院心率可能是AHF的可治疗标.
- 研究结果表明,基于加速度计的R模式刺激可能无法充分解决导致AHF不良结果的慢性无能症.
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