按种族、族裔和性别划分的收缩期心力衰竭人群中传导异常的患病率。
Prevalence of conduction abnormalities in a systolic heart failure population by race, ethnicity, and gender.
作者信息
Hebert Kathy, Quevedo Henry C, Tamariz Leonardo, Dias Andre, Steen Dylan L, Colombo Rosario A, Franco Emiliana, Neistein Sholom, Arcement Lee M
机构信息
University of Miami, Miller School of Medicine, Division of Cardiology, FL, USA.
出版信息
Ann Noninvasive Electrocardiol. 2012 Apr;17(2):113-22. doi: 10.1111/j.1542-474X.2012.00492.x.
BACKGROUND
There is paucity of data regarding conduction abnormalities in the Hispanic population with systolic heart failure (HF). We aimed to evaluate the prevalence of electrocardiogram (ECG) abnormalities in a systolic HF population, with attention to the Hispanic population.
METHODS
A cross sectional study of 926 patients enrolled in a systolic HF disease management program. ECGS were obtained in patients with an ejection fraction (EF) ≤ 40% by echocardiography at enrollment. Univariate and multivariate analysis adjusted by ethnicities was performed.
RESULTS
White patients exhibited higher prevalence of atrial fibrillation (14.7%) than black patients (8.0%, P = 0.01) whereas Hispanics presented higher prevalence of paced rhythm (14.3% in Hispanics vs. 6.5% in whites and 5.2% in blacks, P<0.01 for both comparisons), higher prevalence of left bundle branch block (LBBB, 14.5% in Hispanics vs. 8.8% in whites and 5.8% in blacks, P = 0.002) and increased frequency of abnormal QT intervals (76.7% in Hispanics) than whites (59.6%) and blacks (69%) patients (P< 0.01 for both comparisons). A QRS interval greater than 120 ms was less prevalent among blacks (15.8% vs. 26.0% in whites and 25.3% in Hispanics, P = 0.01 for both comparisons). Univariate and multivariate analysis disclosed no influence of other characteristics (age, sex, coronary artery disease, hypertension, ejection fraction, medications) in the ECG findings.
CONCLUSIONS
Hispanics with Systolic HF presented with increased prevalence of paced rhythm, LBBB, and abnormal QT intervals. Attention should be addressed to these ECG variations to recommend additional guidance for therapeutic interventions and provide important prognostic information.
背景
关于西班牙裔收缩性心力衰竭（HF）人群传导异常的数据较少。我们旨在评估收缩性HF人群中心电图（ECG）异常的患病率，并关注西班牙裔人群。
方法
对926名参加收缩性HF疾病管理项目的患者进行横断面研究。在入组时通过超声心动图对射血分数（EF）≤40%的患者进行心电图检查。进行了按种族调整的单因素和多因素分析。
结果
白人患者房颤患病率（14.7%）高于黑人患者（8.0%，P = 0.01），而西班牙裔患者起搏心律患病率更高（西班牙裔为14.3%，白人为6.5%，黑人为5.2%，两组比较P<0.01），左束支传导阻滞（LBBB）患病率更高（西班牙裔为14.5%，白人为8.8%，黑人为5.8%，P = 0.002），且异常QT间期频率高于白人和黑人患者（西班牙裔为76.7%，白人为59.6%，黑人为69%，两组比较P<0.01）。黑人中QRS间期大于120 ms的患病率较低（15.8%，而白人为26.0%，西班牙裔为25.3%，两组比较P = 0.01）。单因素和多因素分析显示，其他特征（年龄、性别、冠状动脉疾病、高血压、射血分数、药物治疗）对心电图结果无影响。
结论
患有收缩性HF的西班牙裔人群起搏心律、LBBB和异常QT间期的患病率增加。应关注这些心电图变化，以便为治疗干预提供更多指导并提供重要的预后信息。
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