Department of Cardiology, J. Brudziński Hospital, Gdynia, Poland.
Kardiol Pol. 2009 Aug;67(8):837-44.
Ventricular arrhythmia (VA) is the most frequent cause of sudden death among patients with non-ischaemic dilated cardiomyopathy (DCM).
To identify the important VA risk factors in patients with DCM.
Eighty-five DCM patients (73 males, mean age 54 years) with DCM and implantable cardioverter defibrillators (ICD) were followed for 21+/-19 months after ICD implantation. The mean follow-up was 21 months. Data from 55 patients with VA recorded in the ICD memory and requiring ICD intervention during follow-up were compared with 30 patients without arrhythmia. Cox regression analysis identified the following univariate predictors of VA: alcoholic aetiology of DCM (0.05), diuretic treatment (0.003), history of cardiac arrest (0.03), right ventricular diastolic diameter (0.001). Both ACE inhibitor (ACEI) and statin treatments were associated with a tendency towards decreased risk of VA. Multivariate logistic analysis identified four predictors as significantly related to VA: alcoholic aetiology (HR 4.8, p=0.008), ACEI treatment (HR 0.4, p=0.01), diuretic treatment (HR 2.6, p=0.015), and statin treatment (HR 0.1, p=0.03).
The majority of patients with DCM and ICD have recurrences of VA. Alcoholic aetiology of DCM is associated with an increase in the incidence of arrhythmias. Treatment with ACEI and statins is associated with a reduction of arrhythmias.
室性心律失常（VA）是缺血性扩张型心肌病（DCM）患者猝死的最常见原因。
确定 DCM 患者中重要的 VA 危险因素。
85 例 DCM 患者（73 名男性，平均年龄 54 岁），在植入埋藏式心脏复律除颤器（ICD）后，DCM 和 ICD 随访 21+/-19 个月。平均随访时间为 21 个月。比较了在随访期间记录在 ICD 记忆中的 55 例 VA 患者和 30 例无心律失常患者的 ICD 干预所需数据。Cox 回归分析确定了 VA 的以下单变量预测因素：DCM 的酒精病因（0.05），利尿剂治疗（0.003），心脏骤停史（0.03），右心室舒张直径（0.001）。ACE 抑制剂（ACEI）和他汀类药物治疗均与 VA 风险降低呈相关趋势。多变量逻辑分析确定了四个与 VA 显著相关的预测因素：酒精病因（HR 4.8，p=0.008），ACEI 治疗（HR 0.4，p=0.01），利尿剂治疗（HR 2.6，p=0.015）和他汀类药物治疗（HR 0.1，p=0.03）。
大多数患有 DCM 和 ICD 的患者都有 VA 的复发。DCM 的酒精病因与心律失常发生率的增加有关。ACEI 和他汀类药物的治疗与心律失常的减少有关。
