Prognostic Significance of Fragmented QRS in Patients with Hypertrophic Cardiomyopathy
Prognostic Significance of Fragmented QRS in Patients with Hypertrophic Cardiomyopathy
复制标题
肥厚型心肌病患者碎片状 QRS 的预后意义
DOI：
10.1159/000471845
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发表时间：
2017-08-01
期刊：
影响因子：
1.9
通讯作者：
Song, Lei
中科院分区：
文献类型：
--
作者：
Lu, Xili;Wang, Wei;Song, Lei
目的：肥厚性心肌病（HCM）患者碎片化QRS （fQRS）与临床结局之间的关系尚不清楚。本研究旨在探讨fQRS在HCM患者预后中的意义。方法：纳入2000 ~ 2012年无相关性HCM患者326例（男性72%，平均年龄52岁），分为有fQRS组和无fQRS组。结果：共有105/326(32.2%)HCM患者在入组时出现fQRS。在5.3±2.4年的随访期间，33例患者死亡，其中30例死于心血管疾病（CVD）。Cox回归分析显示，fQRS预测较高的全因死亡率（校正风险比[HR] 2.24； 95%可信区间[CI] 1.08-4.64; p = 0.030）和心血管疾病死亡率（校正风险比[HR] 2.68; 95% CI 1.22-5.91; p = 0.014）。我们的研究还表明，fQRS增加了心力衰竭相关死亡的风险（校正后比3.75;95% CI 1.24-11.30; p = 0.019）。结论：我们的研究结果表明fQRS与HCM患者的不良临床结局相关。
Objectives: The relationship between a fragmented QRS (fQRS) and clinical outcomes in patients with hypertrophic cardiomyopathy (HCM) remains unclear. This study aimed to investigate the prognostic significance of fQRS in patients with HCM. Methods: Between 2000 and 2012, 326 unrelated patients with HCM (72% male with a mean age of 52 years) were included and were divided into 2 groups: those with fQRS and those without fQRS. Results: A total of 105/326(32.2%) patients with HCM presented with fQRS at enrollment. During a follow-up of 5.3 ± 2.4 years, 33 patients died, 30 of cardiovascular disease (CVD). Cox regression analysis revealed that fQRS predicted a higher risk of all-cause mortality (adjusted hazard ratio [HR] 2.24; 95% confidence interval [CI] 1.08-4.64; p = 0.030) and CVD mortality (adjusted HR 2.68; 95% CI 1.22-5.91; p = 0.014). Our study also showed that fQRS increased the risk of heart failure-related death (adjusted HR 3.75; 95% CI 1.24-11.30; p = 0.019). Conclusions: Our results indicate that fQRS is associated with adverse clinical outcomes in patients with HCM.