QRS延长与高伤心心肌病症的不良心脏改造有关
Hernan L Vera-Sarmiento1, Talha Tanriverdi2, David Hurtado-de-Mendoza3
1Hypertrophic Cardiomyopathy Center of Excellence, Division of Cardiology, University of California San Francisco, San Francisco, CA, United States of America.
Journal of electrocardiology
|November 11, 2024
概括
异常信号平均心电图 (SAECG) 在缩性心肌病 (HCM) 患者中表明显著的结构和电力改造. 这一发现凸显了受影响个体中更严重的全球肌肉病变.
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:
- 信号平均心电图 (SAECG) 检测心肌脱极化,并确定纤维组织中的缓慢导电,这是心室失常 (VAs) 的前体.
- 超性心肌病 (HCM) 呈现心脏纤维化和VA的高发病率,但SAECG显示VA的预测价值有限.
- 根据HCM特定的结构和电气改造的假设,可以解释SAECG的低预测能力.
研究的目的:
- 为了研究SAECG异常发现与高性心肌病 (HCM) 患者的基础结构/电力改造之间的关系.
- 确定HCM特异性重塑是否有助于SAECG对心室失常 (VAs) 的低预测能力.
主要方法:
- 对73名HCM患者进行SAECG,胸前心电回声 (TTE) 和心磁共振 (CMR) 影像的回顾性研究.
- 根据过的QRS持续时间 (fQRSd),根平均平方电压 (RMS40) 和晚期潜力 (LAS40) 将患者分为正常和异常的SAECG组.
- 异常SAECG定义为fQRSd> 114毫秒,RMS40 < 20μV,或LAS40> 38毫秒.
主要成果:
- 大约50%的HCM患者 (37/73) 呈现异常SAECG.
- 异常SAECG组显示显著更高的fQRSd和LAS40,更大的左心脏大小,降低了全球LV纵向应变/应变率,以及早期扩张应变率受损.
- 在异常SAECG组中,CMR显示了较高的LV-质量指数 (LVMI) 和LV痕负担;fQRSd与LVMI和痕质量正相关.
结论:
- 在HCM患者中异常的SAECG与更广泛的结构和电气左心室 (LV) 重建有关.
- 这些发现表明,异常的SAECG反映了HCM中更严重的全球肌肉病.
- 这项研究强调了SAECG异常与HCM中高级心脏重塑之间的联系.
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