电心电图上的QRS碎片化和心肌痕表征在患有缺血性和非缺血性心肌病患者的心脏磁共振成像上的QRS碎片化之间的关系
Meshal AlAnezi1, Scott Barichello1, Hirmand Nouraei1
1University of Toronto, Toronto, Ontario, Canada.
The American journal of cardiology
|October 8, 2025
概括
在心电图上碎片化QRS (fQRS) 可能表明心肌纤维化. 这项研究发现fQRS与视觉痕评估相关,但并非如此.
科学领域:
- 心脏病学 心脏病学
- 医疗成像医学成像
- 电力生理学 电力生理学
背景情况:
- 心电图 (ECG) 上的碎片化QRS (fQRS) 可能表明心肌纤维化.
- 心脏磁共振 (CMR) 的灰色区域预测了接受植入式心脏转换器-除器 (ICD) 的患者的结果.
- 在CMR上fQRS和心肌痕之间的联系需要进一步调查,以改善ICD风险分层.
研究的目的:
- 使用CMR晚期加多增强 (LGE) 评估fQRS和心肌痕 (核心和灰色区域) 之间的关系.
- 为了确定fQRS是否预测ICD治疗的益处.
主要方法:
- 对388名接受CMR和ICD植入的成年患者进行了回顾性分析.
- 分析了fQRS的心电图;评估了LGE的CMR图像.
- 主要终点:综合所有原因死亡率或适当的ICD冲击.
主要成果:
- 在视觉LGE评估中,fQRS与较大的痕负担有关 (p=0.036).
- fQRS与定量LGE措施或灰色区域没有相关性.
- 在多变量分析中,fQRS不是主要结果的独立预测指标 (HR 0.85;p=0.20).
结论:
- 视觉评估的fQRS与心肌痕负担有关.
- fQRS没有提供超出LVEF等既定标志物的ICD治疗益处的额外预测价值.
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