在右心室节奏患者的节奏诱导心肌病的风险预测工具
Yichao Yu1,2, Xiaofei Wang3, Jian Zhang1
1Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
Pacing and clinical electrophysiology : PACE
|December 17, 2025
概括
一个新的工具预测了在接受右心室节拍治疗的患者中诱导节拍心肌病的风险 (PICM). 这有助于为高风险人群选择左束枝节奏,并可能防止心肌损伤.
科学领域:
- 心脏病学 心脏病学
- 生物医学工程 生物医学工程
- 医学诊断 医学诊断 医学诊断
背景情况:
- 节奏诱导心肌病 (PICM) 是与右心室节奏相关的重大风险.
- 识别高风险患者对于预防PICM至关重要.
- 左捆分支节奏是一种减轻PICM风险的替代策略.
研究的目的:
- 开发和验证PICM在接受右心室节奏调节的患者中的预测模型.
- 为风险分层创建一个用户友好的工具 (nomogram).
- 为了指导节奏策略的选择,在适当的时候偏爱左捆分支节奏.
主要方法:
- 对374名接受右心室节拍治疗的患者进行了回顾性分析.
- 使用临床,心声学和心电学数据开发两个预测模型.
- 基于性能和简单性的优秀模型的选择,包括射出分数,左心室末缩直径,QRS持续时间和心房动.
- 使用所选模型构建和验证名ogram.
主要成果:
- 最终的模型包括射出分数,左心室末缩直径,基线QRS持续时间和心房动.
- 命名图显示了中度的区别 (C-统计 = 0.75) 和准确的校准.
- 该模型有效地将患者分为PICM高风险和低风险组.
- 在内部验证 (启动) 和外部验证套件中,性能一致.
结论:
- 一个名图有效预测了3年,5年和8年的PICM风险在接受右心室节拍的正常射出分数的患者.
- 这种工具可以识别哪些患者可能从左捆分支节奏中获益更多.
- 节奏表支持关于初始节奏策略选择的知情决策.
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