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经导管主动脉瓣置换术前QRS梗死评分和QRS时限对新发持续性左束支传导阻滞患者随访左心室收缩末期容积的影响。

Influence of QRS infarct score and QRS duration prior to transcatheter aortic valve replacement on follow-up left ventricular end systolic volume in patients with new persistent left bundle branch block.

作者信息

Hannink Laura G J, Wagner Galen S, Kisslo Joseph, Alenezi Fawaz Abdulaziz M, Shaw Linda K, Hofmann Paul, Zusterzeel Robbert, Phelan Matthew, Velazquez Eric J, Gorgels Anton P M

机构信息

Department of Cardiology, Maastricht University Medical Center, Maastricht, The Netherlands; Duke Clinical Research Institute, Durham, NC, USA.

Department of Medicine, Division of Cardiology, Duke University Medical Center, Durham, NC, USA.

出版信息

J Electrocardiol. 2015 Jul-Aug;48(4):637-42. doi: 10.1016/j.jelectrocard.2015.04.010. Epub 2015 May 1.

Abstract

BACKGROUND

New-onset left bundle branch block (LBBB) is a known complication during Transcatheter Aortic Valve Replacement (TAVR). This study evaluated the influence of pre-TAVR cardiac conditions on left ventricular functions in patients with new persistent LBBB post-TAVR.

METHODS

Only 11 patients qualified for this study because of the strict inclusion criteria. Pre-TAVR electrocardiograms were evaluated for Selvester QRS infarct score and QRS duration, and left ventricular end-systolic volume (LVESV) was used as outcome variable.

RESULTS

There was a trend towards a positive correlation between QRS score and LVESV of r=0.59 (p=0.058), while there was no relationship between QRS duration and LVESV (r=-0.18 [p=0.59]).

CONCLUSION

This study showed that patients with new LBBB and higher pre-TAVR QRS infarct score may have worse post-TAVR left ventricular function, however, pre-TAVR QRS duration has no such predictive value. Because of the small sample size these results should be interpreted with caution and assessed in a larger study population.

摘要

背景

新发左束支传导阻滞(LBBB)是经导管主动脉瓣置换术(TAVR)期间已知的一种并发症。本研究评估了TAVR术前心脏状况对TAVR术后新发持续性LBBB患者左心室功能的影响。

方法

由于纳入标准严格,仅有11例患者符合本研究要求。对TAVR术前心电图进行Selvester QRS梗死评分和QRS时限评估,并将左心室收缩末期容积(LVESV)用作结果变量。

结果

QRS评分与LVESV之间呈正相关趋势,r = 0.59(p = 0.058),而QRS时限与LVESV之间无相关性(r = -0.18 [p = 0.59])。

结论

本研究表明,新发LBBB且TAVR术前QRS梗死评分较高的患者TAVR术后左心室功能可能较差,然而,TAVR术前QRS时限并无此类预测价值。由于样本量较小,这些结果应谨慎解读,并在更大的研究人群中进行评估。

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