左和右分支块与心力衰竭患者的临床结果的关联 保存的喷射分数
Sukhila Reddy1, Lakshmi Kattamuri1, Alok Dwivedi2
1Department of Internal Medicine, Texas Tech University Health Sciences Center, El Paso, Texas.
概括
左束分支阻塞 (LBBB) 和右束分支阻塞 (RBBB) 增加了心血管风险和心力衰竭患者的住院费用. 这些发现凸显了在高高压风患者中对BBB的监测的重要性.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 保存喷射分数 (HFpEF) 的心力衰竭是一种复杂的疾病,具有显著的发病率和医疗保健成本.
- 捆绑分支区块 (BBB),特别是左捆绑分支区块 (LBBB) 和右捆绑分支区块 (RBBB) 对HFpEF心血管结果的影响仍然不完全理解.
- 澄清这些关联对于HFpEF患者的风险分层和管理至关重要.
研究的目的:
- 调查LBBB和RBBB与急性HFpEF住院患者心血管 (CV) 结局之间的关联.
- 为了比较与LBBB和RBBB相关的CV发病率,死亡率和住院费用与HFpEF中的正常QRS持续时间.
- 确定BBB对HFpEF不利结果的独立贡献.
主要方法:
- 一项利用2019年国家住院样本 (NIS) 数据库进行的横截面研究.
- 对成年HFpEF住院病例的分析,分为LBBB,RBBB或正常QRS组.
- 评估临床结果,包括心房动,心室动,完全心脏阻塞,恶性鼻综合征,心脏骤停,住院费用和住院死亡率,使用倾向性得分加权后勤和相对风险模型.
主要成果:
- 该研究分析了334,511次HFpEF住院病例,其中LBBB占2%和RBBB占2.4%.
- 与正常QRS相比,LBBB与心室动,恶性鼻综合征和完全心脏阻塞的几率增加显著相关,以及更高的住院费用.
- RBBB与心房动,心室动,恶性鼻综合征,完全心脏阻塞,心脏骤停和更高的住院费用增加的几率有关. 在对共变量进行调整后,这些关联仍然存在,并在敏感性分析中得到验证.
结论:
- 捆绑分支区块 (LBBB和RBBB) 独立地与急性无补偿HFpEF患者的较高心血管不良结果风险和增加住院费用有关.
- 这些发现强调了在HFpEF群体中承认BBB的临床意义,以改善患者管理和资源配置.
- 尽管风险增加,但在LBBB和RBBB的HFpEF患者中,与正常QRS患者相比,停留时间更短.
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