减速能力：非缺血性扩张型心肌病患者全因死亡率的一种新型预测指标。
Deceleration capacity: A novel predictor for total mortality in patients with non-ischemic dilated cardiomyopathy.
作者信息
Demming Thomas, Sandrock Sarah, Kuhn Christian, Kotzott Laura, Tahmaz Nihat, Bonnemeier Hendrik
机构信息
Universitätsklinik Schleswig Holstein, Campus Kiel, Klinik für Innere Medizin III, Abteilung für Elektrophysiologie und Rhythmologie, Kiel, Germany.
Universitätsklinik Schleswig Holstein, Campus Kiel, Klinik für Innere Medizin III, Abteilung für Elektrophysiologie und Rhythmologie, Kiel, Germany.
出版信息
Int J Cardiol. 2016 Oct 15;221:289-93. doi: 10.1016/j.ijcard.2016.06.205. Epub 2016 Jun 27.
OBJECTIVES
We hypothesized that deceleration capacity (DC), a novel marker of cardiac autonomic modulation, is an independent predictor for mortality in patients with non-ischemic dilated cardiomyopathy (NICM).
BACKGROUND
NICM is associated with a high risk for sudden cardiac death (SCD). However there are no clinically established parameters available for risk stratification beyond LVEF. DC has been previously shown to be a strong independent predictor for total mortality in patients after myocardial infarction.
METHODS
Holter-ECG recordings of 201 patients NICM (83.1% male, mean age: 61.4years, mean LVEF: 33.3%) were analyzed by the method of phase-rectified-signal-averaging (PRSA) to obtain DC.
RESULTS
During a minimum follow-up of 40month 59 patients died. Kaplan Meyer Analysis showed a significantly higher mortality in patients with a DC below 4.5ms (log rank p=0.012) irrespective to the presence of atrial fibrillation.
CONCLUSIONS
Impaired DC is a powerful independent predictor for mortality in patients with NICM.
目的
我们假设减速能力（DC），一种心脏自主神经调节的新标志物，是非缺血性扩张型心肌病（NICM）患者死亡率的独立预测因子。
背景
NICM与心脏性猝死（SCD）的高风险相关。然而，除左心室射血分数（LVEF）外，尚无临床确定的风险分层参数。DC先前已被证明是心肌梗死后患者总死亡率的强大独立预测因子。
方法
对201例NICM患者（83.1%为男性，平均年龄：61.4岁，平均LVEF：33.3%）的动态心电图记录采用相位整流信号平均（PRSA）方法进行分析以获得DC。
结果
在至少40个月的随访期间，59例患者死亡。Kaplan-Meier分析显示，无论是否存在心房颤动，DC低于4.5毫秒的患者死亡率显著更高（对数秩检验p = 0.012）。
结论
DC受损是NICM患者死亡率的有力独立预测因子。
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