Patterns of ectopy leading to increased risk of fatal or near-fatal cardiac arrhythmia in patients with depressed left ventricular function after an acute myocardial infarction
Patterns of ectopy leading to increased risk of fatal or near-fatal cardiac arrhythmia in patients with depressed left ventricular function after an acute myocardial infarction
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DOI：
10.1093/europace/eus415
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发表时间：
2013-09-01
期刊：
影响因子：
6.1
通讯作者：
Huikuri, Heikki V.
中科院分区：
文献类型：
--
作者：
Lerma, Claudia;Gorelick, Alexander;Huikuri, Heikki V.
目的：基于一种捕捉心室早搏 (PVC) 特征与动态心电图 (心纹) 中窦性 RR 间期相关的方法，确定评估突发心律失常事件风险的潜在新标志物。使用从 227 名心室功能降低 (左心室射血分数 40) 患者急性心肌梗死后 6 周获得的动态心电图记录来生成心纹。测量指标为：每小时 PVC 数、耦合间隔标准差 (SDCI) 以及最常见形式 PVC 的出现次数 (S-NIB)。根据主要终点进行预测值、生存分析和对临床变量进行调整的 Cox 回归，主要终点定义为心电图记录的致命或接近致命的心律失常事件、任何原因导致的死亡和心源性死亡。高异位率（PVC 每小时 10）是所有终点的预测因子。重复形式的 PVC (S-NIB 83) 是主要终点风险比 3.5 (1.39.5) 和全因死亡风险比 2.8 (1.17.3) 的预测因子，但不是心源性死亡的预测因子。 SDCI 80 ms 是全因死亡和心源性死亡的预测因子，但不是主要终点的预测因子。高异位性、重复形式 PVC 的患病率和低耦合间隔变异性是心肌梗死后致命或近乎致命性心律失常的潜在有用风险标记。
To identify potential new markers for assessing the risk of sudden arrhythmic events based on a method that captures features of premature ventricular complexes (PVCs) in relation to sinus RR intervals in Holter recordings (heartprint).Holter recordings obtained 6 weeks after acute myocardial infarction from 227 patients with reduced ventricular function (left ventricular ejection fraction 40) were used to produce heartprints. Measured indices were: PVCs per hour, standard deviation of coupling interval (SDCI), and the number of occurrences of the most prevalent form of PVCs (S-NIB). Predictive values, survival analysis, and Cox regression with adjustment for clinical variables were performed based on primary endpoint, defined as an electrocardiogram-documented fatal or near-fatal arrhythmic event, death from any cause, and cardiac death. High ectopy (PVCs per hour 10) was a predictor of all endpoints. Repeating forms of PVCs (S-NIB 83) was a predictor of primary endpoint, hazard ratio 3.5 (1.39.5), and all-cause death, hazard ratio 2.8 (1.17.3), but not cardiac death. SDCI 80 ms was a predictor of all-cause death and cardiac death, but not of primary endpoint.High ectopy, prevalence of repeating forms of PVCs, and low coupling interval variability are potentially useful risk markers of fatal or near-fatal arrhythmias after myocardial infarction.