Boveda S, Galinier M, Lagrange P, Delay M, Massabuau P, Dongay B, Prouteau N, Marti J, Fauvel J M, Bounhoure J P
Service de Cardiologie, CHU de Rangueil, 1, avenue Jean-Poulhès, 31403 Toulouse.
Ann Cardiol Angeiol (Paris). 1999 Apr;48(4):258-63.
Half of all deaths occurring in patients with heart failure are sudden deaths probably related to a malignant ventricular arrhythmia. The pathophysiological mechanisms of these arrhythmias are unclear, but left ventricular function, hypokalaemia accentuated by diuretics and treatments altering inotropism play a definite role. Because of the diversity of aetiologies generating heart failure, the multiplicity of fatal arrhythmias and the multifactorial origin of these arrhythmias, there is no formal marker for the risk of sudden death in patients with heart failure, at the present time. In addition to the NYHA classification and detection of episodes of syncope, assessment of these patients must be as complete as possible, at least including repeated evaluation of the ejection fraction, Holter ECG monitoring and detection of delayed ventricular potentials.
心力衰竭患者中发生的所有死亡事件，有一半为猝死，可能与恶性室性心律失常有关。这些心律失常的病理生理机制尚不清楚，但左心室功能、利尿剂加重的低钾血症以及改变心肌收缩力的治疗方法都起到了一定作用。由于导致心力衰竭的病因多样、致命性心律失常种类繁多且这些心律失常具有多因素起源，目前尚无针对心力衰竭患者猝死风险的正式标志物。除了纽约心脏病协会（NYHA）分级和晕厥发作检测外，对这些患者的评估必须尽可能全面，至少包括对射血分数的反复评估、动态心电图监测以及延迟心室电位检测。
