Clinical usefulness of left ventricular outflow tract velocity time integral for heart failure with reduced ejection fraction with rapid atrial fibrillation during landiolol treatment.
Clinical usefulness of left ventricular outflow tract velocity time integral for heart failure with reduced ejection fraction with rapid atrial fibrillation during landiolol treatment.
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兰地洛尔治疗期间左心室流出道速度时间积分对于射血分数降低伴快速心房颤动的心力衰竭的临床用途。
DOI：
10.1016/j.jjcc.2021.09.008
复制
发表时间：
2021
影响因子：
2.5
通讯作者：
K. Kimura
中科院分区：
文献类型：
--
作者：
N. Iwahashi;J. Kirigaya;T. Abe;M. Horii;H. Takahashi;Y. Hanajima;Yuichiro Kimura;Y. Minamimoto;K. Okada;Y. Matsuzawa;K. Hibi;M. Kosuge;T. Ebina;K. Tamura;K. Kimura
背景兰地洛尔能有效治疗快速心房颤动（AF）合并急性失代偿性心力衰竭（ADHF）患者。我们试图确定超声心动图在预测预后的作用。MethodsAmong 314例患者，共115 ADHF患者射血分数降低和快速AF入组。用兰地洛尔治疗，使心率（HR）降至<110 bpm，24 h内HR变化（ΔHR）>20%。兰地洛尔的剂量每2小时增加一次;然后，我们在基线、2小时和24小时重复进行超声心动图检查。出院后随访180天，检查心脏性死亡和HF住院作为主要不良心脏事件（MACE）。在出院后180天内，115例患者中有19例（16%）发生MACE（2例心源性死亡，17例HF再住院，5例院内死亡）。多因素分析显示，2 h时左心室流出道速度时间积分（LVOT-VTI）的变化是MACE最显著的预测因素（风险比=1.21，95%可信区间：1.10- 1.83，p =0.0001）。Kaplan-Meier曲线显示，最小剂量兰地洛尔治疗时LVOT-VTI恶化者为MACE的高危患者（χ2= 30.9，p <0.0001）。我们可以通过两点超声心动图检测高危患者。2013年11月1日注册-前瞻性研究https：upload.umin.ac.jp/cgi-open-bin/ctr/ctr.cgi?功能=眉毛&行动=眉毛&类型=摘要&语言=J&recptno= R 000023203
BackgroundLandiolol enables us to treat the patients with rapid atrial fibrillation (AF) with acute decompensated heart failure (ADHF) efficiently. We sought to determine the role of echocardiography in predicting the prognosis.MethodsAmong 314 patients, a total 115 ADHF patients with reduced ejection fraction and rapid AF were enrolled. They received landiolol treatment to decrease the heart rate (HR) to <110 bpm and change HR (ΔHR) of >20% within 24 h. The dose of landiolol was increased every 2 h; then, we performed echocardiography repeatedly, at baseline, 2 h, and 24h. We followed the patients after discharge for 180 days, and checked cardiac death and HF hospitalization as major adverse cardiac events (MACE).ResultsDuring initial hospitalization, 5 patients (4%) died. During 180 days after discharge, 19 (16%) out of 115 patients experienced MACE (2 cardiac death, 17 HF rehospitalization, 5 in-hospital death). Multivariate analysis showed that the change in left ventricular outflow tract-velocity time integral (LVOT-VTI) at 2 h was the most significant predictor for MACE (hazard ratio =1.21, 95% confidence interval: 1.10-1.83,p=0.0001). Kaplan-Meier curves demonstrated the patients with deteriorated LVOT-VTI at minimum dose landiolol suggested the high-risk patients for MACE (χ2=30.9,p<0.0001).ConclusionsDuring landiolol treatment, the patients with deteriorated LVOT-VTI predicted the poor prognosis. We may detect the high-risk patients by two-point echocardiography.UMIN000020084. Registered 1 November 2013 – prospective studyhttps://upload.umin.ac.jp/cgi-open-bin/ctr/ctr.cgi?function=brows&action=brows&type=summary&language=J&recptno=R000023203
日本GGOS的报告
DOI：
--
发表时间：
2022
期刊：
影响因子：
--
作者：
T. Otsubo;B. Miyahara;Y. Yokot
通讯作者：
Y. Yokot
影响因子：
3.3
作者：
Tsutsui, Hiroyuki;Isobe, Mitsuaki;Yamashina, Akira
通讯作者：
Yamashina, Akira
影响因子：
39.3
作者：
Hindricks, Gerhard;Potpara, Tatjana;Watkins, Caroline L.
通讯作者：
Watkins, Caroline L.