Spontaneous Non-Sustained Ventricular Tachycardia and Premature Ventricular Contractions and Their Prognostic Relevance in Patients with Cancer in Routine Care.
Spontaneous Non-Sustained Ventricular Tachycardia and Premature Ventricular Contractions and Their Prognostic Relevance in Patients with Cancer in Routine Care.
复制标题
DOI：
10.3390/cancers13102303
复制
发表时间：
2021-05-12
期刊：
影响因子：
5.2
通讯作者：
Anker MS
中科院分区：
文献类型：
--
作者：
Albrecht A;Porthun J;Eucker J;Coats AJS;von Haehling S;Pezzutto A;Karakas M;Riess H;Keller U;Landmesser U;Haverkamp W;Anker SD;Anker MS
目前尚不清楚常规护理中的癌症患者在 24 小时心电图中出现室性心律失常的频率。我们发现，与对照组相比，癌症患者中发生≥3次和≥4次心跳的非持续性室性心动过速的频率更高。癌症患者的常规 24 小时心电图中发现每天 ≥4 次心搏和 ≥20 次室性早搏的非持续性室性心动过速具有预后相关性。目的：目前尚不清楚在常规护理中发现的癌症患者是否在 24 小时心电图 (ECG) 中显示室性心律失常，以及检测到时是否具有预后相关性。方法和结果：我们纳入了 261 名被转诊至心脏病科进行 24 小时心电图检查的连续癌症患者和 35 名年龄和性别相似的健康对照者进行分析。为了减少选择偏倚，已知左心室射血分数<45%的癌症患者不包括在分析中。癌症患者中，持续时间≥3次和≥4次的非持续性室性心动过速（NSVT）发作频率高于对照组（17% vs. 0%，p = 0.0008；10% vs. 0%，p = 0.016）。与对照组相比，癌症患者的 24 小时室性早搏 (PVC) 频率并不更高（中位数 (IQR)，26 (2-360) 与 9 (1-43)，p = 0.06；≥20 PVC 分别为 53% vs. 37%，p = 0.07）。在随访期间（长达 7.2 年，中位 15 个月），癌症患者中有 158 名 (61%) 死亡（1 年/3 年/5 年死亡率：45% [95%CI 39–51%]、66% [95%CI 59–73%]、73% [95%CI 64–82%]）。在单变量和多变量生存分析中，≥4次心跳和≥20次室性心动过速/24小时的非持续性室性心动过速独立预测死亡率，并根据所有其他单变量死亡率预测因子以及相关临床因素进行调整，包括癌症分期和类型、体力状态（ECOG）、既往潜在心脏毒性抗癌药物治疗、冠状动脉疾病、钾浓度和血红蛋白（多变量调整风险比：NSVT≥4次心跳[HR] 1.76，p = 0.022]，≥20 PVC/24 小时 [HR 1.63，p < 0.0064]）。结论：癌症患者常规 24 小时心电图显示 NSVT ≥4 次心跳和 ≥20 次 PVC/天具有预后相关性。
It is largely unknown how frequently cancer patients seen in routine care show ventricular arrhythmias during 24-h electrocardiograms. We have found that non–sustained ventricular tachycardia episodes of ≥3 and ≥4 beats duration were more frequent in cancer patients than controls. Non–sustained ventricular tachycardia with ≥4 beats and ≥20 premature ventricular contractions/day seen in routine 24-h electrocardiograms of patients with cancer carry prognostic relevance. Aims: It is largely unknown whether cancer patients seen in routine care show ventricular arrhythmias in 24 h electrocardiograms (ECGs), and whether when they are detected they carry prognostic relevance. Methods and Results: We included 261 consecutive cancer patients that were referred to the department of cardiology for 24 h ECG examination and 35 healthy controls of similar age and sex in the analysis. To reduce selection bias, cancer patients with known left ventricular ejection fraction <45% were not included in the analysis. Non–sustained ventricular tachycardia (NSVT) episodes of either ≥3 and ≥4 beats duration were more frequent in cancer patients than controls (17% vs. 0%, p = 0.0008; 10% vs. 0%, p = 0.016). Premature ventricular contractions (PVCs)/24 h were not more frequent in cancer patients compared to controls (median (IQR), 26 (2–360) vs. 9 (1–43), p = 0.06; ≥20 PVCs 53% vs. 37%, p = 0.07). During follow-up, (up to 7.2 years, median 15 months) of the cancer patients, 158 (61%) died (1-/3-/5-year mortality rates: 45% [95%CI 39–51%], 66% [95%CI 59–73%], 73% [95%CI 64–82%]). Both non-sustained ventricular tachycardia of ≥4 beats and ≥20 PVCs/24 h independently predicted mortality in univariate and multivariate survival analyses, adjusted for all other univariate predictors of mortality as well as relevant clinical factors, including cancer stage and type, performance status (ECOG), prior potentially cardiotoxic anti-cancer drug therapy, coronary artery disease, potassium concentration, and haemoglobin (multivariate adjusted hazard ratios: NSVT ≥4 beats [HR 1.76, p = 0.022], ≥20 PVCs/24 h [HR 1.63, p < 0.0064]). Conclusions: NSVT ≥4 beats and ≥20 PVCs/day seen in routine 24 h ECGs of patients with cancer carry prognostic relevance.
登录
查看更多内容
影响因子：
6.1
作者：
Priori, Silvia G.;Blomstrom-Lundqvist, Carina;Van Veldhuisen, Dirk J.
通讯作者：
Van Veldhuisen, Dirk J.
影响因子：
39.3
作者：
Zamorano, Jose Luis;Lancellotti, Patrizio;Windecker, Stephan
通讯作者：
Windecker, Stephan
晚期癌症也是一种心力衰竭综合征：一种假设。
DOI：
10.1002/jcsm.12694
发表时间：
2021-06
期刊：
Journal of cachexia, sarcopenia and muscle
影响因子：
--
作者：
Anker MS;Sanz AP;Zamorano JL;Mehra MR;Butler J;Riess H;Coats AJS;Anker SD
通讯作者：
Anker SD
DOI：
10.1073/pnas.1601650113
发表时间：
2016-09-13
影响因子：
11.1
作者：
Karlstaedt, Anja;Zhang, Xiaotian;Taegtmeyer, Heinrich
通讯作者：
Taegtmeyer, Heinrich
影响因子：
18.2
作者：
Anker, Markus S.;Ebner, Nicole;von Haehling, Stephan
通讯作者：
von Haehling, Stephan