使用康奈尔产品来预测左捆分支区域节奏的心声回应
Selda Murat1, Gurbet Özge Mert1, Fatih Enes Durmaz2
1Department of Cardiology, Eskişehir Osmangazi University, Eskişehir, Türkiye.
概括
电心电图上的康奈尔产品 (CP) 可以预测哪些心力衰竭患者的左捆分支堵塞将显著受益于左捆分支区域节奏 (LBBAP). 较低的CP值表明对这种新型节拍疗法超级反应的可能性更高.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 心脏衰竭管理的管理
背景情况:
- 左捆支部区域节奏 (LBBAP) 为心脏重同步治疗提供了双心室节奏的替代方案.
- 确定可能从LBBAP中获得显著益处的患者 (超级响应者) 对于优化治疗结果至关重要.
- 左捆分支阻塞 (LBBB) 复杂化了心力衰竭管理和节奏策略.
研究的目的:
- 评估电心电图康奈尔产品 (CP) 在识别LBBAP超级响应者的预测能力.
- 评估基线CP值与LBBAP后左心室喷射率 (LVEF) 显著改善之间的关联.
- 为了确定CP是否是一个独立的预测LBBB的心力衰竭患者对LBBAP的超级反应.
主要方法:
- 对接受LBBAP的32名LBBB心力衰竭患者进行了回顾性分析.
- 纳入标准:LVEF≤35%,QRS持续时间≥150毫秒,鼻节律,以及最佳的医疗治疗.
- 从12导心电图计算基线康奈尔产物 (CP) 的计算,使用[(RaVL + SV3) x QRS持续时间];超级响应定义为6个月后≥15%的LVEF增加.
主要成果:
- 在研究队列中的53% (n=17) 观察到LBBAP的超级反应.
- 与非超级响应者相比,超级响应者表现出明显较低的基线康奈尔产品值 (3788.4对5174.0 mm*ms,P=0.044).
- 多变量分析确定较低的CP (OR:1.01,P=0.036) 和较低的静脉缩性肺动脉压 (OR:1.08,P=0.041) 作为超级反应的独立预测因素.
结论:
- 康奈尔产品 (CP) 是一种简单,易于使用的心电标记器,可以预测对左捆分支区域节奏 (LBBAP) 的超级反应.
- 较低的基线CP值与LBBAP后显著改善LVEF的可能性更高.
- CP可以帮助临床医生选择LBBAP的患者,优化心脏再同步治疗的结果.
相关概念视频
01:30Pulse rhythm
Pulse rhythm refers to the pattern of pulsations within specific intervals, offering valuable insights into the regularity or irregularity of the heart's beats as observed through the pattern of pulsation within specific intervals. A regular pulse exhibits a consistent heart rate with uniform waveforms and pulsation force, variations of which can be classified as normal, weak, or bounding.
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac muscle...
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac muscle...
01:11Assessment of radial pulse
Assessment of Radial Pulse
The radial pulse, located at the wrist, is often the preferred site for assessing peripheral pulse because of its accessibility and dependability. The process of determining the radial pulse involves several steps:
The radial pulse, located at the wrist, is often the preferred site for assessing peripheral pulse because of its accessibility and dependability. The process of determining the radial pulse involves several steps:
01:25Assessment of apical radial pulse
Apical-Radial (A-R) Pulse Assessment
The A-R pulse assessment involves simultaneous evaluation of the apical and radial pulses. When the apical and radial pulse rates vary, this assessment helps identify a pulse deficit.
Pre-Procedural Preparation
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Pre-Procedural Preparation
01:25Correlation between ECG and Cardiac Cycle
The electrical signals recorded on an electrocardiogram (ECG) occur before the mechanical processes of contraction and relaxation during the cardiac cycle.
A cardiac action potential originates in the SA node and spreads throughout the atria and the AV node in approximately 0.03 seconds. This results in the P wave in an ECG and triggers atrial contraction. The action potential is then briefly slowed at the AV node, allowing the atria to contract and fill the ventricles with blood before...
A cardiac action potential originates in the SA node and spreads throughout the atria and the AV node in approximately 0.03 seconds. This results in the P wave in an ECG and triggers atrial contraction. The action potential is then briefly slowed at the AV node, allowing the atria to contract and fill the ventricles with blood before...
01:15Heart Sounds
Heart sounds are generated by the turbulence in blood flow due to the closing of heart valves. These sounds are best perceived slightly away from the valves, where the blood flow disseminates the sound.
Auscultation is the process of listening to these internal body sounds using a stethoscope. The heart produces four types of sounds, but only two—S1 and S2—can usually be heard with a stethoscope.
S1, also known as the "lub" sound, is caused by the closure of atrioventricular (A-V) valves at the...
Auscultation is the process of listening to these internal body sounds using a stethoscope. The heart produces four types of sounds, but only two—S1 and S2—can usually be heard with a stethoscope.
S1, also known as the "lub" sound, is caused by the closure of atrioventricular (A-V) valves at the...
01:24ECG Interpretation of Rhythms
An electrocardiogram (ECG)graphically represents the heart's electrical activity on ECG paper or a monitor.
Components of the Electrocardiogram
The primary components of a normal ECG waveform in Normal sinus rhythm(NSR) include the P wave, PR interval, QRS complex, ST segment, T wave, and occasionally a U wave.
ECG waveforms are divided by vertical and horizontal lines at standard intervals.
The horizontal axis measures time and rate, and the vertical axis measures amplitude or voltage. When...
Components of the Electrocardiogram
The primary components of a normal ECG waveform in Normal sinus rhythm(NSR) include the P wave, PR interval, QRS complex, ST segment, T wave, and occasionally a U wave.
ECG waveforms are divided by vertical and horizontal lines at standard intervals.
The horizontal axis measures time and rate, and the vertical axis measures amplitude or voltage. When...