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与心脏再同步治疗的左束枝异常患者的收缩不对称性和生存率

Nareen Kader¹, Liv Therese Holm-Nielsen¹, Bhupendar Tayal¹

¹Department of Cardiology, Aalborg University Hospital, Hobrovej 18-22, 9100 Aalborg, Denmark.

European heart journal. Imaging methods and practice

|July 24, 2024

概括

一种新的心脏壁运动指标,即收缩不对称指数 (ICA),可以预测接受心脏再同步治疗 (CRT) 的心力衰竭患者的存活率. 更高的ICA值表明更好的长期结果和CRT后的存活率.

科学领域:

心脏病学心脏病学
生物医学工程生物医学工程
心声回声扫描 (Echocardiography) 是一种心声回声扫描.

背景情况:

目前的心脏再同步治疗 (CRT) 患者选择依赖于电气,而不是机械参数.
大约三分之一的心力衰竭 (HF) 患者尽管遵守指导方针,但CRT没有益处.
延迟左心室 (LV) 激活是关键标准,但其对CRT反应的预测能力有限.

研究的目的:

为了评估收缩不对称指数 (ICA) 的预后生存意义,在接受CRT的左捆分支阻塞 (LBBB) 的HF患者中.
为了确定ICA是否可以改善患者选择CRT与当前的电气标准相比.
研究ICA作为一种新的机械参数,用于预测CRT后的长期结果.

主要方法:

对367名患有LBBB的HF患者进行CRT的分析.
计算ICA使用LV变异率值从顶2D回声心脏学.
使用卡普兰-梅尔分析和考克斯比例危险模型评估ICA的预测价值.
评估ICA在预测临床子组的生存率及其对风险模型的影响.

主要成果:

较高的基线ICA值,特别是ICA-2ch,与无事件生存率的增加有关.
对ICA的未调整危险比为0.28 (95% CI 0.18-0.46),表明不良事件风险降低.
较高的ICA-2ch (>0.319 s−1) 经过协变量调整后,持续预测生存率.
较低的ICA-2ch值与不良事件发生率的急剧增加有关.
纳入ICA-2ch提高了LBBB患者多变量风险模型的预测准确度.

结论:

植入前ICA为CRT接受者提供了长期生存和不良结果的定量预后值.
ICA代表了一个有前途的机械生物标志物,用于优化CRT患者选择.
这项研究强调了机械异步评估在预测CRT响应方面的重要性.

关键词:

心肌病性心脏病 - 心肌病性心脏病冠状动脉疾病是一种冠状动脉疾病.左束子分支异常的异常情况死亡率死亡率这是一个心脏起器.

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