肥厚型心肌病患者碎裂QRS波的预后意义
Prognostic Significance of Fragmented QRS in Patients with Hypertrophic Cardiomyopathy.
作者信息
Lu Xili, Wang Wei, Zhu Ling, Wang Yilu, Sun Kai, Zou Yubao, Tian Tao, Hui Rutai, Wang Jizheng, Kang Lianming, Song Lei
机构信息
Department of Cardiovascular Internal Medicine, Hypertension Center, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
出版信息
Cardiology. 2017;138(1):26-33. doi: 10.1159/000471845. Epub 2017 May 30.
OBJECTIVES
The relationship between a fragmented QRS (fQRS) and clinical outcomes in patients with hypertrophic cardiomyopathy (HCM) remains unclear. This study aimed to investigate the prognostic significance of fQRS in patients with HCM.
METHODS
Between 2000 and 2012, 326 unrelated patients with HCM (72% male with a mean age of 52 years) were included and were divided into 2 groups: those with fQRS and those without fQRS.
RESULTS
A total of 105/326(32.2%) patients with HCM presented with fQRS at enrollment. During a follow-up of 5.3 ± 2.4 years, 33 patients died, 30 of cardiovascular disease (CVD). Cox regression analysis revealed that fQRS predicted a higher risk of all-cause mortality (adjusted hazard ratio [HR] 2.24; 95% confidence interval [CI] 1.08-4.64; p = 0.030) and CVD mortality (adjusted HR 2.68; 95% CI 1.22-5.91; p = 0.014). Our study also showed that fQRS increased the risk of heart failure-related death (adjusted HR 3.75; 95% CI 1.24-11.30; p = 0.019).
CONCLUSIONS
Our results indicate that fQRS is associated with adverse clinical outcomes in patients with HCM.
目的
肥厚型心肌病（HCM）患者中碎裂QRS波（fQRS）与临床结局之间的关系仍不明确。本研究旨在探讨fQRS在HCM患者中的预后意义。
方法
纳入2000年至2012年间326例无亲缘关系的HCM患者（72%为男性，平均年龄52岁），并将其分为两组：有fQRS组和无fQRS组。
结果
共有105/326（32.2%）例HCM患者在入组时出现fQRS。在5.3±2.4年的随访期间，33例患者死亡，其中30例死于心血管疾病（CVD）。Cox回归分析显示，fQRS预示全因死亡风险更高（调整后风险比[HR]2.24；95%置信区间[CI]1.08 - 4.64；p = 0.030）以及CVD死亡风险更高（调整后HR 2.68；95%CI 1.22 - 5.91；p = 0.014）。我们的研究还表明，fQRS增加了心力衰竭相关死亡风险（调整后HR 3.75；95%CI 1.24 - 11.30；p = 0.019）。
结论
我们的结果表明，fQRS与HCM患者不良临床结局相关。
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