Incidence and predictors of early and late sudden cardiac death in hospitalized Japanese patients with new-onset systolic heart failure.
Incidence and predictors of early and late sudden cardiac death in hospitalized Japanese patients with new-onset systolic heart failure.
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DOI：
10.1002/joa3.12618
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发表时间：
2021-10
影响因子：
2
通讯作者：
Hagiwara N
中科院分区：
文献类型：
--
作者：
Minami Y;Kikuchi N;Shiga T;Suzuki A;Shoda M;Hagiwara N
心力衰竭(HF)和低左室射血分数(LVEF)患者是心脏性猝死(SCD)的高危人群。合理的心衰治疗可改善左心室射血分数，降低心源性心脏病的风险。这项研究的目的是评估日本新发的收缩期心衰患者中SCD的发生率和预测因素，并调查影响LVEF改善的因素。我们对连续住院的174例新发心力衰竭患者进行了回顾性研究，其左心室射血分数≤为35%(中位年龄66岁；男性为71%)。主要结果是SCD、持续性室性心律失常和适当的植入性心律转复除颤器治疗的综合结果。出院后3、12、36个月主要结局达标率分别为3.9%、8.1%、10.5%。心房颤动是出院后12个月内主要结局的显著预测因素(优势比，5.87；95%可信区间[CI]，1.60-21.57)。在104例出院后12个月内完成超声心动图随访的患者中，LVEF的变化与SCD呈负相关(优势比/1%增加，0.78；95%可信区间，0.65-0.93)。QRS波群持续时间和B型利钠肽水平分别为130ms和170pg/m L是LVEF改善至35%的预测因素(优势比分别为3.69；95%CI，1.15~11.77；优势比3.19；95%CI，1.33~7.69)。我们的结果显示，在新发的收缩性心衰住院患者中，出院后12个月内出现主要结局的发生率很高。改善的LVEF可能会降低晚期SCD的风险。日本新发心力衰竭患者出院后12个月内(尤其是3个月内)和全因死亡的发生率较高(心源性猝死、持续性室性心动过速/纤颤和适当的植入性心律转复/除颤器治疗)和全因死亡，其中新发心力衰竭和左心室射血分数≤为35%。
Patients with heart failure (HF) and low left ventricular ejection fraction (LVEF) are at high risk of sudden cardiac death (SCD). Optimal HF treatment can improve LVEF and reduce the risk of SCD. The aim of this study was to evaluate the incidence and predictors of SCD in Japanese patients with new‐onset systolic HF and to investigate factors that affect LVEF improvement. We retrospectively studied 174 consecutive hospitalized patients with new‐onset HF and LVEF ≤35% (median age, 66 years; men, 71%). The primary outcome was a composite of SCD, sustained ventricular arrhythmias, and appropriate implantable cardioverter‐defibrillator therapy. The cumulative rates of meeting of the primary outcome at 3, 12, and 36 months after discharge were 3.9%, 8.1%, and 10.5%, respectively. Atrial fibrillation was a significant predictor of the primary outcome within 12 months after discharge (odds ratio, 5.87; 95% confidence interval [CI], 1.60–21.57). Among 104 patients who completed follow‐up echocardiography within 12 months after discharge, changes in LVEF were inversely associated with SCD (odds ratio/1% increase, 0.78; 95% CI, 0.65–0.93). A QRS duration <130 ms and a B‐type natriuretic peptide level <170 pg/mL were predictors of LVEF improvement to >35% (odds ratio, 3.69; 95% CI, 1.15–11.77; odds ratio, 3.19; 95% CI, 1.33–7.69, respectively). Our results showed a high incidence of meeting of the primary outcome within 12 months after discharge in hospitalized patients with new‐onset systolic HF. An improved LVEF may reduce the risk of late SCD. There were high incidences of the primary outcome (sudden cardiac death, sustained ventricular tachycardia/fibrillation, and appropriate implantable cardioverter‐defibrillator therapy) and all‐cause death within 12 months, especially within 3 months, after discharge in hospitalized Japanese patients with new‐onset heart failure and LVEF ≤35%.
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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：
158.5
作者：
Hohnloser, SH;Kuck, KH;Connolly, SJ
通讯作者：
Connolly, SJ
影响因子：
4.8
作者：
Teeter, William A.;Thibodeau, Jennifer T.;Drazner, Mark H.
通讯作者：
Drazner, Mark H.
DOI：
10.1016/0735-1097(90)90357-u
发表时间：
1990-09-01
影响因子：
24
作者：
POOLE, JE;MATHISEN, TL;GREENE, HL
通讯作者：
GREENE, HL
影响因子：
2.1
作者：
Roeger, Susanne;Rosenkaimer, Stefanie L.;Borggrefe, Martin
通讯作者：
Borggrefe, Martin