植入式心脏复律除颤器治疗的心力衰竭患者血清尿酸水平与室性快速心律失常的关系

Association between Serum Uric Acid Level and Ventricular Tachyarrhythmia in Heart Failure Patients with Implantable Cardioverter-Defibrillator.

作者信息

Nodera Minoru, Suzuki Hitoshi, Matsumoto Yoshiyuki, Kamioka Masashi, Kaneshiro Takashi, Yoshihisa Akiomi, Ohira Tetsuya, Takeishi Yasuchika

机构信息

Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan.

Department of Arrhythmia and Cardiac Pacing, Fukushima Medical University, Fukushima, Japan.

出版信息

Cardiology. 2018;140(1):47-51. doi: 10.1159/000488851. Epub 2018 May 25.

DOI:10.1159/000488851

PMID:29804115

Abstract

OBJECTIVES

The uric acid (UA) level is related to cardiac events and mortality, but little is known about the clinical significance of serum UA with regard to the ventricular tachyarrhythmia (VT) risk in patients with heart failure.

METHODS

The present study enrolled 56 patients with ischemic and nonischemic cardiomyopathy (37 males, mean age 64.7 ± 11.1 years) who received prophylactic implantable cardioverter-defibrillator (ICD) implantation. Based on a median serum UA value, study subjects were divided into two groups: serum UA < 6.1 mg/dL (group L, n = 29) and ≥6.1 mg/dL (group H, n = 27). Echo- and electrocardiograms (QRS duration and QTc intervals) were examined in each group.

RESULTS

During the follow-up period (30 ± 8 months), 22 (39%) patients had appropriate ICD therapies for sustained VT. There was no significant difference in the electro- and echocardiographic data between both groups. However, appropriate ICD therapies were significantly higher in group H than in group L (p = 0.02). In multivariate analysis, UA was an independent predictor of appropriate ICD therapies (hazard ratio 1.826, 95% confidence interval 1.248-2.671, p = 0.002).

CONCLUSIONS

Serum UA levels might be a predictor of VT, providing new aspects regarding the decision to adapt ICD implantation in patients with heart failure.

摘要

目的

尿酸（UA）水平与心脏事件及死亡率相关，但关于血清尿酸在心力衰竭患者室性快速心律失常（VT）风险方面的临床意义知之甚少。

方法

本研究纳入了56例接受预防性植入式心脏复律除颤器（ICD）植入的缺血性和非缺血性心肌病患者（37例男性，平均年龄64.7±11.1岁）。根据血清UA值的中位数，研究对象被分为两组：血清UA<6.1mg/dL（L组，n = 29）和≥6.1mg/dL（H组，n = 27）。对每组进行超声心动图和心电图检查（QRS时限和QTc间期）。

结果

在随访期（30±8个月）内，22例（39%）患者接受了针对持续性VT的适当ICD治疗。两组的心电图和超声心动图数据无显著差异。然而，H组的适当ICD治疗明显高于L组（p = 0.02）。多因素分析中，UA是适当ICD治疗的独立预测因素（风险比1.826，95%置信区间1.248 - 2.671，p = 0.002）。