Impact of a poor functional capacity on the clinical outcomes in patients with a pacemaker implantation -Results from the Japanese Heart Rhythm Society Registry.
Impact of a poor functional capacity on the clinical outcomes in patients with a pacemaker implantation -Results from the Japanese Heart Rhythm Society Registry.
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DOI：
10.1002/joa3.12459
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发表时间：
2021-03
影响因子：
2
通讯作者：
Okumura K
中科院分区：
文献类型：
--
作者：
Arimoto T;Watanabe E;Kohno R;Shimeno K;Kikuchi K;Doi A;Inoue K;Nitta T;Nogami A;Abe H;Okumura K
功能容量（FC）与各种心血管疾病的死亡率相关。本研究的目的是检查心脏起搏器植入是否改善FC并影响预后。我们前瞻性入组了621例初次起搏器植入者（年龄76 ± 9岁，50.7%为男性）。在植入期间和之后定期通过代谢当量（MET）评估FC。患者被先验地分为差FC（<2 METs，n = 40）、中FC（2 ≤ METs < 4，n = 239）和好FC（≥4 METs，n = 342）。起搏器植入后3个月，差FC或中度FC患者改善为良好FC的比例为43%。三种FC的分布保持在这些水平，直到1年随访后（P = .18）。在中位随访2.4年期间，71例患者（11%）发生心血管住院，35例（5.6%）发生全因死亡。一项多变量考克斯分析显示，基线时FC较差是心血管住院（风险比[HR] 2.494，P = .012）和全因死亡（HR 3.338，P = .016）的独立预测因子。起搏器植入后一年，8名FC较差的患者的死亡率高达37.5%（P <0.01）。大约一半的差或中度FC患者在起搏器植入后3个月改善为良好FC。基线FC可预测预后，起搏器植入后FC改善的患者预后更好。我们研究了功能容量（FC）的时间趋势以及FC与接受初始起搏器植入患者预后之间的关系。本研究的主要发现是：（i）43%的FC较差或中度患者在起搏器植入后3个月改善为良好FC，（ii）FC较差是住院和总死亡率的独立预测因素，（iii）起搏器植入后1年FC无改善与死亡风险增加相关。
Functional capacity (FC) correlates with mortality in various cardiovascular diseases. The aim of this study was to examine whether cardiac pacemaker implantations improve the FC and affect the prognosis. We prospectively enrolled 621 de novo pacemaker recipients (age 76 ± 9 years, 50.7% male). The FC was assessed by metabolic equivalents (METs) during the implantation and periodically thereafter. The patients were a priori classified into poor FC (<2 METs, n = 40), moderate FC (2 ≤ METs < 4, n = 239), and good FC (≥4 METs, n = 342). Three months after the pacemaker implantation, poor FC or moderate FC patients improved to a good FC by 43%. The distribution of the three FCs remained at those levels until after 1 year of follow‐up (P = .18). During a median follow‐up of 2.4 years, 71 patients (11%) had cardiovascular hospitalizations and 35 (5.6%) all‐cause death. A multivariate Cox analysis revealed that a poor FC at baseline was an independent predictor of both cardiovascular hospitalization (hazard ratio [HR] 2.494, P = .012) and all‐cause death (HR 3.338, P = .016). One year after the pacemaker implantation, the eight who remained with a poor FC had a high mortality rate of 37.5% (P < .01). Approximately half of the poor or moderate FC patients improved to good FC 3 months after the pacemaker implantation. The baseline FC predicted the prognosis, and patients with an improved FC after the pacemaker implantation had a better prognosis. We examined the temporal trends in the functional capacity (FC) and the relationship between the FC and prognosis in patients receiving an initial pacemaker implantation. The major findings of this study were that (i) 43% of the patients with a poor or moderate FC improved to a good FC 3 months after the pacemaker implantation, (ii) a poor FC was an independent predictor of both hospitalization and the total mortality, and (iii) the lack of an improvement in the FC at 1 year after the pacemaker implantation was associated with an increased risk of mortality.
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DOI：
10.4081/monaldi.2016.756
发表时间：
2016-10-14
期刊：
Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace
影响因子：
--
作者：
Iliou, Marie Christine;Blanchard, Jean Christophe;Ledru, Francois
通讯作者：
Ledru, Francois
影响因子：
9.7
作者：
Conraads, Viviane M.;Spruit, Martijn A.;van Veldhuisen, Dirk J.
通讯作者：
van Veldhuisen, Dirk J.
影响因子：
4.8
作者：
Jehn, Melissa;Schmidt-Trucksaess, Arno;Koehler, Friedrich
通讯作者：
Koehler, Friedrich
影响因子：
158.5
作者：
Toff, WD;Camm, J;Skehan, JD
通讯作者：
Skehan, JD
影响因子：
120.7
作者：
BLAIR, SN;KOHL, HW;MACERA, CA
通讯作者：
MACERA, CA