原生QRS持续时间和心力衰竭的结果与轻微减少的射出分数:来自大规模注册表的结果
Finn Ole Kronberg1, Michael Behnes1, Marielen Reinhardt1
1Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
在心力衰竭中延长QRS持续时间与轻微减少的喷射分数 (HFmrEF) 与心力衰竭的住院病例增加有关,但与整体死亡率无关. 这一发现强调了QRS持续时间作为HFmrEF患者的关键预后指标.
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:
- 在心力衰竭中QRS持续时间的预后意义与轻微减少的喷射分数 (HFmrEF) 仍未得到充分研究.
- 作为心室脱极化的衡量标准,QRS持续时间是其他心力衰竭亚型的已知预测结果的指标.
研究的目的:
- 调查原生QRS持续时间对被诊断为HFmrEF的患者临床结果的预后影响.
- 确定延长的QRS持续时间是否预测该患者群体的全因死亡率和心力衰竭相关的再住院.
主要方法:
- 对1627名连续的HFmrEF患者 (2016-2022) 的回顾性分析,使用可用的12个导电图数据.
- 与QRS持续时间≥120毫秒和<120毫秒的患者之间的结果比较.
- 基于左捆分支区块 (LBBB) 与右捆分支区块 (RBBB) 的分层,以及对初级 (30个月全因死亡率) 和二级 (高频相关再住院) 终点的评估.
主要成果:
- 长时间的QRS持续时间 (≥120毫秒) 与长期增加的全因死亡率 (35.1%与28.7%,p=0.057) 并没有显著关联.
- 患有QRS持续时间≥120毫秒的患者表现出与HF相关的再住院风险显著增加 (18.2%对11.9%,p=0.008;调整HR 1.420,p=0.045).
- 在LBBB和RBBB亚组之间没有观察到死亡率或再住院风险的显著差异.
结论:
- 延长本源QRS持续时间是HFmrEF患者与HF相关的再住院增加的独立预测因素.
- 在HFmrEF中,QRS持续时间似乎不是所有原因的长期死亡率的重要预测指标.
- 这些发现强调了QRS持续时间评估对HFmrEF风险分层的重要性.
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