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Eur Heart J:心脏结节病患者风险分层

2022-07-05 MedSci原创 MedSci原创

虽然心脏结节病的死亡率相对较低,但不良事件较为常见,主要是由于致死性室性心律失常事件所致。

近日,心血管领域权威杂志Eur Heart J上发表了一篇研究文章,该研究旨在评估心脏结节病这一诊断不足疾病的预后及预测因素。

根据2016年日本循环协会或2014年心脏节律协会的标准,研究人员将2001年至2017年期间在回顾性多中心注册且诊断为心脏结节病的患者纳入本项目。该研究的主要终点是全因死亡、心衰住院和致死性室性心律失常事件的复合事件,每一个组成事件都为本研究的探索性终点。

该研究共纳入了512名登记的患者,在平均1042天(四分位数范围为518-1917天)的随访期内,研究人员观察到148例合并事件(56例心衰住院,99例致死性室性心律失常事件和49例全因死亡)。研究人员主要终点、全因死亡、心力衰竭住院和致死性室性心律失常事件的10年估计事件发生率分别为48.1%、18.0%、21.1%和31.9%。

多变量Cox回归显示,室性心动过速(VT)或房颤病史[风险比(HR)为2.53,95%可信区间(CI)为1.59-4.00,P<0.001]、脑钠肽(BNP)水平对数转换(HR为1.28,95%CI为1.07-1.53,P=0.008)、左室射血分数(每增加5%的HR为0.94,95%CI为0.88-1.00,P=0.046)和室速诊断后射频消融(HR为2.65,95%CI为1.02-6.86,P=0.045)可独立预测了主要终点事件。

由此可见,虽然心脏结节病的死亡率相对较低,但不良事件较为常见,主要是由于致死性室性心律失常事件所致。低左室射血分数,高BNP水平,伴有室速/纤颤病史,需要消融治疗室速的患者具有较高风险。

原始出处:

Takeru Nabeta,et al.Risk stratification of patients with cardiac sarcoidosis: the ILLUMINATE-CS registry Get access Arrow.European Heart Journal.2022.https://academic.oup.com/eurheartj/advance-article-abstract/doi/10.1093/eurheartj/ehac323/6619356?redirectedFrom=fulltext

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    2022-07-06 zhaojie88
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    2022-07-06 slcumt

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