在患有左心室环状痕的患者中,心律失常风险分层
Vanda Parisi1,2,3, Maddalena Graziosi1,3, Luis R Lopes4,5
1Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
European journal of preventive cardiology
|November 1, 2024
概括
非缺血性心肌病患者的左心室环状痕与危及生命的心律失常有关. 前部Q波,扩大的QRS和更大的LV体积预测这些事件,正常的心电图表明风险较低.
科学领域:
- 心脏病学 心脏病学
- 心脏成像 - - 心脏成像
- 电子生理学 电子生理学
背景情况:
- 在心磁共振 (CMR) 上的左心室 (LV) 环状痕与非缺血性心肌病的恶性心律失常有关.
- 确定危及生命的失律事件 (LAE) 的危险因素对于患者管理至关重要.
研究的目的:
- 为了全面评估LV环状痕现型.
- 为了确定LAE的风险因素,包括心脏突然死亡 (SCD),SCD中断和持续的心室动脉冲动.
主要方法:
- 在6个中心对115名LV环状痕患者进行了回顾性分析.
- 纳入标准:环状LV痕 (≥3连续段,心下/心中壁LGE) 加上遗传变异,家族病史或不律性心肌病变的诊断.
- 多变量分析以确定LAE的预测因素,基于心电图和预测变量进行风险分层.
主要成果:
- 该研究包括115名患者 (42%为女性,中位数年龄为39岁).
- 在随访期间 (中位数为4.6年),84%的患者没有LAE (3.8事件/100患者年).
- 对LAE的独立预测因素包括前部Q波 (HR 1.030),QRS宽度 (HR 4.642) 和LV终端-透气体体积指数 (LVEDVi) (HR 1.011).
- 三种风险类别显示生存率下降:正常心电图 (100%),没有预测因子的异常心电图 (65%) 和具有预测因子的异常心电图 (49%).
结论:
- 这种LV环状痕现型与高发性心律不整的高发率有关.
- 前方Q波,QRS延长和LVEDVi增加是LAE的独立风险因素.
- 一个正常的心电图可以在这个患者群体中识别出一个低风险的子组.
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