在患有异常扩展性心肌病的患者中,连续心电图变化
Anil Kumar Choudhary1, Ajay Bahl1, Yash Paul Sharma1
1PGIMER, Chandigarh, India.
Indian heart journal
|February 28, 2025
概括
在患有扩张性心肌病症 (DCM) 的患者中,QRS持续时间通常会随着时间的推移而增加,这表明心室导电恶化. 这种进展与传导缺陷和左束分支区块 (LBBB) 的更高患病率有关.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 医学诊断 医学诊断 医学诊断
背景情况:
- 在扩张性心肌病 (DCM) 中,广泛的QRS持续时间和捆绑分支阻塞与患者不良结果有关.
- 关于DCM患者QRS持续时间和形态演变的长期数据很少.
- 了解这些变化对于预测预后和指导治疗至关重要.
研究的目的:
- 通过使用连续心电图 (ECG) 来调查DCM患者心室激活和心房 (AV) 导电的长期变化.
- 评估QRS持续时间和形态在至少5年的随访期间的进展.
- 为了将QRS参数的变化与心室导电缺陷的发展相关联.
主要方法:
- 从165名DCM患者的序列心电图的回顾性分析.
- 在2003年至2022年期间收集的数据,随访时间至少为5年.
- 评估QRS持续时间,形态和捆绑分支块的存在.
主要成果:
- 平均QRS持续时间从基线时的106.2 ± 25.3毫秒显著增加到最后一次随访时的114.2 ± 29毫秒 (p < 0.0001).
- 在患有较高心室导电缺陷 (68%) 的患者中观察到QRS持续时间增加≥10毫秒.
- 13.8%的患者经历了QRS扩大,超过50%的患者发展出左束分支块 (LBBB) 模式.
结论:
- 在DCM患者中,QRS持续时间往往会长期延长,这意味着心室导电的恶化.
- 渐进的QRS扩大和LBBB的发展是这个队列中的重要发现.
- 这些心电图变化凸显了DCM电气异常的动态性质及其与传导系统疾病的关联.
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