Ning Xiaohui, Ye Xuerui, Si Yanhua, Yang Zihe, Zhao Yunzi, Sun Qi, Chen Ruohan, Tang Min, Chen Keping, Zhang Xiaoli, Zhang Shu
State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, China.
Department of Nuclear Medicine, Anzhen Hospital, China.
J Electrocardiol. 2018 Jul-Aug;51(4):742-746. doi: 10.1016/j.jelectrocard.2018.03.010. Epub 2018 Mar 21.
We investigated the prevalence of ventricular tachycardia/ventricular fibrillation (VT/VF) in Post-infarction left ventricular aneurysm (PI-LVA) patients and analyze clinical outcomes in patients presenting with VT/VF.
575 PI-LVA patients were enrolled and investigated by logistic regression analysis. Patients with VT/VF were followed up, the composite primary endpoint was cardiac death and appropriate ICD/external shocks.
The incidence of sustained VT/VF was 11%. Logistical regression analysis showed male gender, enlarged LV end diastolic diameter (LVEDD) and higher NYHA class were correlated with VT/VF development. During follow up of 46 ± 15 months, 19 out of 62(31%) patients reached study end point. Multivariate Cox regression analysis revealed that enlarged LVEDD and moderate/severe mitral regurgitation (MR) were independently predictive of clinical outcome.
Male gender, enlarged LVEDD and higher NYHA class associated with risk of sustained VT/VF in PI-LVA patients. Among VT/VF positive patients, enlarged LVEDD and moderate/severe MR independently predicted poor clinical prognosis.
我们调查了心肌梗死后左心室室壁瘤（PI-LVA）患者室性心动过速/心室颤动（VT/VF）的患病率，并分析了出现VT/VF患者的临床结局。
纳入575例PI-LVA患者，采用逻辑回归分析进行研究。对VT/VF患者进行随访，复合主要终点为心源性死亡和适当的植入式心律转复除颤器（ICD）/体外除颤。
持续性VT/VF的发生率为11%。逻辑回归分析显示，男性、左心室舒张末期内径（LVEDD）增大和纽约心脏协会（NYHA）分级较高与VT/VF的发生相关。在46±15个月的随访期间，62例患者中有19例（31%）达到研究终点。多变量Cox回归分析显示，LVEDD增大和中度/重度二尖瓣反流（MR）是临床结局的独立预测因素。
男性、LVEDD增大和NYHA分级较高与PI-LVA患者持续性VT/VF的风险相关。在VT/VF阳性患者中，LVEDD增大和中度/重度MR独立预测不良临床预后。
