在急性心肌炎期间出现心室节律失常的发生率和预测因素:一项多中心研究
Moshe Rav-Acha1, Kushal Shah2, Tal Hasin1
1Integrated Heart Center, Shaare Zedek Hospital, Hebrew University, Jerusalem, Israel.
JACC. Clinical electrophysiology
|April 25, 2024
概括
患有腹腔失常的急性心肌炎患者面临高的长期风险. 最初的单形心室性心动减速和左心室功能障碍预测复发和死亡率,指导植入式心脏转换器-除器的决策.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 心血管成像 - 心血管成像
背景情况:
- 与腹腔失常 (VA) 相关的急性心肌炎 (AM) 的管理具有挑战性,特别是在早期植入式心脏转换器-除器 (ICD) 的使用方面.
- 鉴定长期VA复发和死亡风险的患者至关重要.
研究的目的:
- 为了确定长期VA复发的流行率和AM患者的整体死亡率初始VA.
- 在这个队列中确定持续的VA复发和死亡率的预测因素.
主要方法:
- 69名AM患者的多中心回顾性分析,记录了初始VA.
- 排除以前心肌梗塞,心力衰竭或VA患者.
- 综合终点:持续的VA和总体死亡率在中位数为5.5年的随访期间.
主要成果:
- 39%的患者达到复合终点 (24例持续的VA,11例死亡).
- 最初持续的单形心室性心跳动 (MMVT) 和排泄前的左心室功能障碍 (LVEF <50%) 是显著的预测因素.
- 多变量分析证实MMVT (HR: 5.17) 和LV功能障碍 (HR: 4.57) 是独立的预测因素.
结论:
- 初始VA的AM患者患有住院后VA复发和死亡的高风险.
- 最初的MMVT和放电前的LV功能障碍是关键的独立预测因素.
- 在高风险的VAAM患者中考虑ICD植入是有必要的.
相关概念视频
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