在鼻节律期间使用心电成像对心室节律失调基质的非侵入性评估:NIAVAS研究
Jana Reventos-Presmanes1, Ismael Hernández-Romero2, Berta Pellicer-Sendra3
1Arrhythmia Section, Institut Clínic Cardiovascular, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain; ITACA Institute, Universitat Politècnica de València, València, Spain; Corify Care SL, Madrid, Spain.
电心图像 (ECGI) 显示心脏痕区域激活分散的增加,有助于识别风险患心室低心率 (VT) 的患者. 这种功能性成像补充了LGE-CMR,用于更好的静脉瘤风险分层.
科学领域:
- 心血管成像和电生理学.
- 心脏节律失常的研究研究.
背景情况:
- 晚期加多增强心磁共振 (LGE-CMR) 识别了心室动脉障碍 (VT) 的结构基质,但缺乏功能信息.
- 非侵入性心电成像 (ECGI) 提供了识别缓慢导电区域的潜力,补充了LGE-CMR用于VT风险分层.
研究的目的:
- 为了评估心室节律失常基质和区域ECGI标记物之间的关系,在阴道节律在患有缺血性心肌病 (ICM) 的患者.
- 评估ECGI在区分有或没有先前VT和对照患者的有用性.
主要方法:
- 分析了72名患者 (29名ICM与LGE-CMR进行静脉管切除,17名ICM与ICD没有静脉管切除,26名对照).
- 在ECGI衍生的区域激活分散 (rAD) 和伪区域传导速度 (pseudo-rCV) 中,在痕和健康区域之间进行了比较.
- 在一个子组 (n=16),ECGI识别的减速区域与电解剖学绘图相关.
主要成果:
- 与健康区域相比,痕区域呈现出明显更高的rAD (46.3 ± 2.2毫秒) 和降低的伪rCV (149.9 ± 3.0厘米/秒) (P < .001).
- 在绘图子组中,ECGI确定了70.4%的减速区,这些区域显示了增加的rAD (64.9 ± 5.4 ms,P < .001).
- 平均rAD差异化ICM患者与没有先前VT (AUC0.75) 和从对照组中识别的ICM患者 (AUC0.93).
结论:
- 新的区域ECGI方法表明,增加RAD可以识别与心律失常基质相关的异常.
- ECGI可以帮助识别患有静脉瘤风险的患者,作为LGE-CMR的宝贵补充工具.
- 这种方法增强了患有缺血性心肌病的患者的非侵入性静脉瘤风险分层.
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