侧面QRS振幅与心脏再同步治疗后的结果独立相关:推进患者选择?
Sander Trenson1, Peter C Kahr2, Judith M Schwaiger2
1Department of Cardiology, University Heart Center Zurich, Zurich, Switzerland; Department of Cardiovascular Sciences, University Hospital Leuven, Leuven, Belgium; Department of Cardiology, AZ Sint-Jan Bruges, Bruges, Belgium.
Heart rhythm
|October 24, 2024
概括
侧面心电图线索中的低QRS振幅预示着心脏再同步治疗 (CRT) 患者的不良结果. 在V6中3mV的门标识出高风险个体,可能改善CRT选择.
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:
- 心脏再同步治疗 (CRT) 对心力衰竭患者至关重要.
- 很大一部分患者对CRT没有反应.
- 需要改进患者选择标准,以优化CRT的结果.
研究的目的:
- 调查基线QRS振幅与CRT后患者结果之间的关联.
- 为了确定预测CRT响应的潜在QRS振幅值.
主要方法:
- 一个跨国,双中心队列 (n=361) 的回顾性分析,带有导出和验证组.
- 在侧导线 (I和V6) 中量化内在的,CRT前的QRS振幅.
- 综合终点:所有原因的死亡率,VAD植入或心脏移植在5年内.
主要成果:
- 在线索I和V6中的更高QRS振幅与不良结果的风险较低相关.
- 确定了最佳切断值:I的6mV和V6的3mV.
- V6中的3mV切断值显著预测了结果,在外部验证中降低了65%的风险.
结论:
- 侧面心电图线索中的低QRS振幅与CRT患者的较差结果有关.
- 在V6中3mV的切断是CRT成功的强有力的预测指标.
- 进一步的研究应该探索QRS振幅在CRT患者选择中的附加值.
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