现实世界治疗患有鼻节功能障碍和心力衰竭的患者,使用保存的射出分数
Nicole Habel1, Sarah Rosemas2, Lucas Higuera2
1University of Vermont Medical Center, Burlington, Vermont, USA.
Pacing and clinical electrophysiology : PACE
|February 27, 2026
概括
永久心脏起器 (PPM) 植入在患有鼻节功能障碍和心力衰竭与保留喷射分数 (HFpEF) 的患者中不太常见. 这些患者经历了更大的疾病负担,突出了对优化治疗策略的需求.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 心脏衰竭管理的管理
背景情况:
- 鼻节功能障碍 (SND) 通常需要永久起器 (PPM) 植入.
- 由于对心力衰竭恶化的担忧,心力衰竭与保留喷射分数 (HFpEF) 复杂化了PPM决策.
- 在SND患者与同时存在的HFpEF患者中,关于PPM利用和疾病负担的现实数据有限.
研究的目的:
- 为了比较永久心脏起器 (PPM) 的利用率和疾病负担,在患有鼻节功能障碍 (SND) 和心力衰竭与保留喷射分数 (HFpEF) 的患者中,与单独患有SND的患者相比.
- 在医疗保险人口中,对这些患者群体的临床结果进行表征.
主要方法:
- 对医疗保险行政索赔数据的回顾性分析.
- 鉴定被诊断为SND的患者,根据HFpEF的存在或不存在进行分层.
- 临床结果的比较,包括PPM植入率,住院 (HF,AF),AV阻塞,心力衰竭与减少喷射率 (HFrEF),心肌梗塞,中风和死亡率.
主要成果:
- SND+HFpEF队列 (N=26,986) 的年龄较大,女性比SND-only队列 (N=74,269) 更多.
- 在SND+HFpEF组中,PPM植入率明显较低 (HR=0.811,p<0.0001).
- 在SND+HFpEF患者中,HF住院率 (HR=2.229),AF住院率 (HR=1.174),第二/第三度AV阻塞 (HR=1.364) 和HFrEF (HR=1.640) 的比率更高.
结论:
- 与SND和HFpEF患者相比,SND和HFpEF患者的PPM利用率较低,总体疾病负担较高.
- 这些发现强调了在HFpEF的存在下,SND的潜在治疗不足.
- 需要进一步的研究,以优化复杂的SND+HFpEF患者群体的治疗途径.
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