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Int J Cardiol:Takotsubo综合征中不良院内结局的心电图预测因子

2019-06-23 xing.T MedSci原创

由此可见,T波倒置在TS中很常见,并且由于VT/VF风险较低而导致MACE风险降低。

Takotsubo综合征(TS)是一种威胁生命的急性心力衰竭综合征。然而,对于TS中较差结果的危险因素知之甚少,并且没有定义高风险ECG标准。近日,心血管领域权威杂志International Journal of Cardiology上发表了一篇研究文章,研究人员试图确定TS中危及生命的院内并发症的心电图预测因子。 

研究人员使用全国范围的瑞典血管造影和血管成形术登记中心(SCAAR)获得了2008年6月至2019年2月期间在Sahlgrenska大学医院接受冠状动脉造影的所有连续患者的数据。对于所有TS患者,研究人员进行了深入的图表检查以确认TS诊断。对于已确诊TS的患者,研究人员随后评估了住院期间获得的所有ECG。主要终点是住院期间主要心脏不良事件(MACE)的发生,定义为死亡、室性心动过速或纤颤(VT/VF),或房室传导阻滞≥2或心搏停止>10s的复合事件。

研究人员确定了215例TS患者(平均年龄69±13岁; 93%为女性)。MACE发生于34例患者(16%),其中20例患有VT/VF(9.3%)。没有临床变量与MACE显著相关。MACE患者比没有MACE的患者更不可能有窦性心律(85% vs. 96%,p=0.025)或T波倒置(29% vs. 51%,p=0.025)。倾向评分调整后,T波倒置与较低的MACE风险(调整后的比值比[AdjOR]为0.28,95%置信区间[CI]为0.10-0.76,p=0.012)和VT/VF(AdjOR为0.24,95%CI为0.06-0.94,p=0.041)独立相关。 

由此可见,T波倒置在TS中很常见,并且由于VT/VF风险较低而导致MACE风险降低。 

原始出处:

SandeepJha,et al.Electrocardiographic predictors of adverse in-hospital outcomes in the Takotsubo syndrome.International Journal of Cardiology.2019.https://doi.org/10.1016/j.ijcard.2019.06.021

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