在门诊性心力衰竭的再同步-逆心电阻力试验中,三角形QRS和CRT后的结果
Daniel Lancini1, Michelle Samuel2, Corey Smith1
1Heart Rhythm Service, QEII Health Sciences Centre, Halifax, Nova Scotia, Canada.
Heart rhythm
|October 11, 2024
概括
德尔塔QRS持续时间 (ΔQRSd) 预测心脏再同步治疗 (CRT) 患者的结果. 阳性 ΔQRSd 表示死亡和心力衰竭住院的风险更高,突出其预后价值.
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:
- 心脏再同步疗法 (CRT) 对左心室缩功能障碍和延长QRS持续时间的患者有好处.
- CRT改善心脏电机同步,并减少不良临床事件.
研究的目的:
- 评估三角 QRS 持续时间 (ΔQRSd) 在临床反应中对CRT的预测作用.
- 确定CRT后QRS持续时间的变化是否与患者的结果相关.
主要方法:
- 分析RAFT研究 (门诊性心力衰竭试验的再同步-减振) 的数据.
- 包括813名接受CRT并有可用的基线和植入后心电图的患者.
- 计算了ΔQRSd作为CRT节拍前后QRS持续时间的差异;主要结局是死亡和心力衰竭住院的综合结果.
主要成果:
- 中位 ΔQRSd 是 -2 ms; 55% 的患者的 ΔQRSd 是 ≤0.
- ΔQRSd独立地预测了CRT患者的复合结局 (HR,1.012;95% CI,1.008-1.017).
- 与对照组相比,DQRSd>0的患者表现出复合结局的比率增加.
结论:
- ΔQRSd是CRT接受者的长期死亡率和心力衰竭住院治疗的独立预测指标.
- 在CRT后QRS持续时间的变化提供了有价值的预后信息.
- 这一指标可以帮助优化CRT患者的选择和管理.
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