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JAHA:扩张型心肌病患儿心率升高与生存率的关系

2020-07-30 MedSci原创 MedSci原创

在扩张型心肌病儿童中,心率升高与死亡和心脏移植的风险增加相关。有必要对扩张型心肌病患儿心率增高与疾病严重程度的关联进行进一步研究,并将其作为潜在的治疗目标。

心衰成年人,心率升高与生存率降低有关。近日,血管疾病领域权威杂志JAHA上发表了一篇研究文章,研究人员旨在明确扩张型心肌病患儿心率升高是否与死亡或心脏移植风险增加相关。

这项研究是对小儿心肌病登记处的数据进行的分析,包含1994年至2011年期间诊断为扩张型心肌病的557名儿童(51%为男性,中位年龄为1.8岁)的基线数据、年度随访和调查事件(移植或死亡)。升高的心率定义为高于儿童平均心率的2个或更多个SD(根据年龄调整)。该研究的主要结局是心脏移植和死亡。

比起具有正常心率的儿童,年龄较大(中位年龄为2.3岁 vs 0.9岁;P<0.001)的192名儿童(34%)的心率升高,更可能出现心力衰症状(83% vs. 67%;P<0.001),心室功能更差(z值中位数缩短分数,分别为-9.7和-9.1;P=0.02),更有可能接受抗充血治疗(分别为96% vs. 86%;P<0.001)。在控制年龄、心室功能和心脏药物的情况下,升高的心率与死亡(调整后的风险比[HR]为2.6;P<0.001)以及死亡或移植(调整后的HR为1.5;P=0.01)独立相关。

由此可见,在扩张型心肌病儿童中,心率升高与死亡和心脏移植的风险增加相关。有必要对扩张型心肌病患儿心率增高与疾病严重程度的关联进行进一步研究,并将其作为潜在的治疗目标。

原始出处:

Joseph W. Rossano.et al.Elevated Heart Rate and Survival in Children With Dilated Cardiomyopathy: A Multicenter Study From the Pediatric Cardiomyopathy Registry.J AM HEART ASSOC.2020.https://www.ahajournals.org/doi/full/10.1161/JAHA.119.015916

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    2020-08-07 lsj637
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    2020-08-01 zhaohui6731
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    2020-07-30 ms3000000449926787

    学习了~

    0

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    2020-07-30 ms4000000715427489

    很受用!

    0

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2018 EACVI专家共识文件:多模式影像学检查在扩张型心肌病的诊断、危险分层以及治疗中的应用

扩张型心肌病由左心室或双心室存在扩张和收缩障碍定义,在没有异常负荷条件和冠状动脉疾病的情况下足以解释这些改变。本文的主要目的时针对多模式影像学检查在扩张型心肌病的诊断、危险分层以及治疗中的应用提供指导建议。

扩张型心肌病全心衰竭合并重度睡眠呼吸暂停综合征患者麻醉处理1例

患者,男,57岁,因间断气短、憋气4年余,加重半年余于2015年4月入院。4年前诊断为扩张型心肌病、心力衰竭,本次入院诊断重度睡眠呼吸暂停综合征(OSAHS)。体格检查:听诊双肺呼吸音清,心界向左扩大,律不齐,心音低钝,心尖区可闻及2/6级收缩期杂音。

Circulation:青春期肥胖显著增加成年后罹患心肌病的风险

心肌病是年轻人心衰的一种常见且日益增加的原因,但与心肌病风险相关的可改变的生活方式因素尚未在年轻人中进行充分的研究。肥胖是公认的早期心力衰竭的预测因素。青少年时期肥胖与成年后罹患心肌病是否存在相关性?本研究是一个国家范围的前瞻性的队列研究,共纳入了于1969年-2005年期间服兵役的1 668 893位青少年男生(平均18.3岁)。起始时,记录体重指数(BMI)、血压和疾病,以及体能和肌肉强度的测

老年男性,反复胸闷、气喘5年,加重半月

患者5年前开始出现活动后胸闷、气喘,曾在外院诊断为扩张型心肌病,长期服用美托洛尔、氯沙坦钾、呋塞米等药物治疗,病情控制稳定。20天前患者自行停药,半月前开始出现胸闷、气喘,稍动即喘,伴夜间阵发性呼吸困

Circulation:特发性扩张型心肌细胞中存在的永久性病毒基因组

B组肠病毒是急性心肌炎的常见病因,也是慢性心肌炎和扩张型心肌病的先兆,还是心脏移植的首要原因。目前,在扩张型心肌病的发展过程中所涉及的特定的病毒功能尚不明确。从扩张型心肌病患者心肌组织的RNA中鉴定肠病毒RNA 5’端序列。经二代RNA测序,体外构建模拟在人类样本中发现的肠病毒RNA序列的病毒cDNA克隆,并在培养的原代人心肌细胞中评估其复制和对宿主细胞功能的影响。主要鉴定出以5'端基因组RNA缺

Circulation:与扩张型心肌病密切相关的12个基因罕见变异

扩张型心肌病(DCM)是一种遗传异质性疾病,临床实验室检测到了100多个所谓的疾病基因。但许多基因最初是根据候选基因研究确定的,这些研究没有充分考虑到背景种群差异。在本研究中,研究人员在2538位DCM患者中评估了56个常用基因的蛋白编码区域罕见变异的突变频率,与912位健康对照和60706位参考人群的进行对比,以鉴定与显性单基因DCM密切相关的临床基因。研究人员采用TruSight心脏测序pan

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