心脏衰竭中心室导电延迟的患病率和预后值,其中保留了喷射分数
Anouk Achten1, Jerremy Weerts1, Johan van Koll1
1Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands.
International journal of cardiology. Heart & vasculature
|February 10, 2025
概括
在心力衰竭中,心室导电延迟与保存的喷射分数 (HFpEF) 是不常见的. 然而,较长的QRS持续时间,作为延迟的标志物,预测HFpEF患者,特别是男性的不良结果.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 心脏衰竭研究研究
背景情况:
- 心力衰竭与保留喷射分数 (HFpEF) 的病理生理学是复杂的,并未完全理解.
- 评估心室导电延迟 (VCD) 作为HFpEF中的表型至关重要.
- QRS 持续时间和矢量心脏 QRS 面积可以表示 VCD.
研究的目的:
- 评估HFpEF患者中VCD表型的流行率.
- 调查QRS持续时间,QRS面积和HFpEF中不良结果之间的关系.
- 确定VCD是否与心力衰竭住院和死亡风险增加有关.
主要方法:
- 包括连续的门诊HFpEF患者.
- 从心电图 (ECG) 测量QRS持续时间.
- 从心电图的矢量心脏图分析得出的QRS面积.
- 分析QRS持续时间和区域作为分类和连续变量.
- 评估了HF住院和所有原因死亡率与复合结果的关联.
主要成果:
- 在349名HFpEF患者中,70%的QRS持续时间<100毫秒;9%的QRS持续时间≥120毫秒.
- 25%的患者QRS面积大于43.1μVs;4%的患者QRS面积大于69μVs.
- 较长的QRS持续时间,而不是QRS区域,与不良结果的增加有关 (HR每5毫秒增加=1.06,P=0.033).
- 这种关联主要在男性患者中观察到.
结论:
- 在HFpEF中,明显的VCD表型 (QRS持续时间≥120 ms或QRS区域≥69 μVs) 的患病率较低.
- 一个QRS持续时间>100毫秒,存在于30%的患者,独立预测不良结果.
- 需要进一步的研究来阐明QRS持续时间对HFpEF结果的机制和临床影响.
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