额面平面QRS-T角度是心力衰竭中心室失常的预测因子,具有保存的射出分数
Çağrı Zorlu1, Barış Açıkel2, Sefa Erdi Ömür1
1Department of Cardiology, Tokat Gaziosmanpasa University Hospital, Tokat, Turkey.
概括
额面平面QRS-T角度,一个易于测量的心电图参数,预测长期心室节律失常和心力衰竭的死亡率与保存喷射分数 (HFpEF) 患者. 58.63度的门值表明风险更高.
科学领域:
- 心脏病学 心脏病学
- 电力生理学 电力生理学
- 心脏衰竭研究研究
背景情况:
- 心电图上的心室再极化参数可以预测心律失常和死亡率.
- 保存弹射率心力衰竭 (HFpEF) 与减少弹射率心力衰竭 (HFrEF) 的死亡率相似,但研究较少.
- 评估心室再极化,特别是正面平面QRS-T角度,对于HFpEF风险分层至关重要.
研究的目的:
- 在HFpEF患者中研究心室心律失常,死亡率和ECG衍生的心室复极化参数之间的关系.
- 具体评估前面平面QRS-T角度对该人群中不良心脏事件的预测值.
主要方法:
- 从811名HFpEF患者的心电图,心声图和实验室数据的回顾性分析.
- 从心电图计算正面平面QRS-T角度 (fQRS-T角度).
- 在平均48个月的随访期间,预期记录心室动脉冲动,心室动或心脏突然死亡.
主要成果:
- 经历心脏事件的患者 (180/811) 有显著更高的NT-proBNP,左心房大小/体积,Tp-e间隔,Tp-e/QTc比率和fQRS-T角度.
- 多变量分析确定NT-proBNP和fQRS-T角度作为死亡率的独立预测因素.
- ROC分析显示,fQRS-T切线角度为58.63度,灵敏度为81.2%,预测心脏事件的特异性为79.3%. 卡普兰-梅尔分析证实,fQRS-T角度>58.63度的死亡率更高.
结论:
- 额面平面QRS-T角度是一种易于且廉价获得的心电图标志物,可预测HFpEF患者的长期心室失律.
- 这个参数为HFpEF患者提供了有价值的风险分层,有助于识别患有心脏不良事件风险较高的人.
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