患有慢性左子分支阻塞的患者心肌病的特征 接受右心室节奏调节
Temidayo A Abe1, Favour Markson2, Daniel J Friedman3
1Division of Cardiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Pacing and clinical electrophysiology : PACE
|August 8, 2025
概括
慢性左捆支部阻塞 (LBBB) 增加了右心室节奏 (RVP) 患者的缩性心力衰竭风险. 这种情况还导致左心室功能恶化,心脏再同步治疗 (CRT) 升级的需求增加.
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:
- 左捆支部阻塞 (LBBB) 和右心室节奏 (RVP) 可以导致心脏力学异常和心肌病.
- 在接受RVP的患者中,慢性LBBB可能会增加心力衰竭和死亡的风险.
研究的目的:
- 在接受RVP的患者中调查慢性LBBB和不良心脏事件之间的关联.
- 评估慢性LBBB对发生性静心性心力衰竭和全因死亡率的影响.
主要方法:
- 利用TrinetX Analytics网络数据库进行患者识别 (2014年1月至2024年1月).
- 包括接受心脏起器植入的患者,不包括先前心力衰竭,设备或CRT患者,LVEF<50%.
- 分析了RVP植入后发生的缩性心力衰竭和全因死亡率的主要结果.
主要成果:
- 在70,526名患者中,有3916人 (5.6%) 患有慢性LBBB.
- 在倾向分数匹配后,慢性LBBB与心性心力衰竭风险增加有关 (HR:1.39),但并非全因死亡率.
- 患有LBBB和心力衰竭的患者显示LVEF降低,CRT升级率更高.
结论:
- 在RVP患者中,慢性LBBB与静心性心力衰竭的风险更高有关.
- 在慢性LBBB患者中观察到左心室功能恶化和CRT升级的可能性增加.
- 这些发现强调了在RVP患者管理中考虑LBBB的重要性.
相关概念视频
01:18Dysrhythmias IV: Characteristics of Bradyarrhythmias
118
Bradyarrhythmias are cardiac rhythm disorders characterized by a slower-than-normal heart rate, typically defined as fewer than 60 beats per minute. Some of which are discussed here:Sinus BradycardiaSinus bradycardia presents a heart rate lower than 60 beats per minute, with a regular rhythm originating from the SA node. The ECG typically shows normal P waves preceding each QRS complex, a normal PR interval (0.12 to 0.20 seconds), and a normal QRS duration (0.06 to 0.10 seconds).First-Degree AV...
118
01:29Cardiomyopathy III: Hypertrophic Cardiomyopathy
48
Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
48
01:30Cardiomyopathy II: Dilated Cardiomyopathy
22
Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
22
01:29Disturbances in Heart Rhythm
1.2K
Arrhythmia or dysrhythmia refers to an abnormal heart rhythm caused by a defect in the heart's conduction system. It can cause the heart to beat irregularly, too quickly, or too slowly, leading to symptoms like chest pain, shortness of breath, and fainting. Factors such as stress, caffeine, alcohol, nicotine, cocaine, certain drugs, congenital defects, diseases, and electrolyte abnormalities can trigger arrhythmias.
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
1.2K
01:29Cardiomyopathy IV: Restrictive Cardiomyopathy
31
Restrictive cardiomyopathy (RCM) is a rare heart muscle disease characterized by impaired ventricular filling due to stiffened ventricular walls, leading to significant diastolic dysfunction.EtiologyRestrictive cardiomyopathy can arise from both inherited and acquired diseases, many of which are systemic. It is categorized into four main types: infiltrative, storage, non-infiltrative, and endomyocardial diseases.Infiltrative diseases, such as amyloidosis, lead to RCM by depositing amyloid...
31
01:26Imbalances in Cardiac Output
1.5K
The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
1.5K