Ay Nuray Kahraman, Enhos Asim, Ay Yasin, Bakhshaliyev Nijad, Nadir Aydin, Karacop Erdem, Celikkale Ilke, Uluganyan Mahmut, Ozdemir Razaman, Goktekin Omer
Department of Cardiology, Bezmialem Vakif University, Fatih, 34093 Istanbul, Turkey.
Department of Cardiology, Bezmialem Vakif University, Fatih, 34093 Istanbul, Turkey.
J Electrocardiol. 2018 Nov-Dec;51(6):923-927. doi: 10.1016/j.jelectrocard.2018.07.015. Epub 2018 Jul 18.
Although transcatheter aortic valve implantation (TAVI) can successfully correct aortic narrowing, pre-existing pathophysiological alterations in the left ventricle are still a concern in terms of long-term mortality. This study aimed to examine the predictive role of fQRS morphology on long-term prognosis in patients undergoing TAVI due to severe aortic stenosis.
A total of 117 patients undergoing TAVI due to severe aortic stenosis were included in this retrospective cohort study. Patients were assigned into two groups based on the presence (n = 36) or absence (n = 81) of fQRS. Predictors of long-term survival were estimated.
In-hospital mortality was higher in fQRS group (5.5% vs. 1.2%, p = 0.0224). In the long-term, fQRS (OR: 3.06, 95% CI 1.29-7.27, p: 0.01), LVEF <50% (OR: 2.54, 95% CI 1.07-6.02, p: 0.03) and presence of atrial fibrillation (OR: 2.42, 95% CI 1.05-5.60, p: 0.03) emerged as significant independent predictors of short survival.
Presence of fQRS on ECG, an indirect indicator of myocardial fibrosis, seems to have the potential to be used as a prognostic marker after TAVI procedure. Large prospective studies are warranted.
尽管经导管主动脉瓣植入术（TAVI）能够成功纠正主动脉狭窄，但左心室先前存在的病理生理改变仍是长期死亡率方面的一个关注点。本研究旨在探讨fQRS形态对重度主动脉瓣狭窄患者接受TAVI后的长期预后的预测作用。
本回顾性队列研究纳入了117例因重度主动脉瓣狭窄接受TAVI的患者。根据是否存在fQRS将患者分为两组（存在fQRS组，n = 36；不存在fQRS组，n = 81）。评估长期生存的预测因素。
fQRS组的院内死亡率更高（5.5%对1.2%，p = 0.0224）。在长期随访中，fQRS（比值比：3.06，95%可信区间1.29 - 7.27，p：0.01）、左心室射血分数<50%（比值比：2.54，95%可信区间1.07 - 6.02，p：0.03）以及心房颤动的存在（比值比：2.42，95%可信区间1.05 - 5.60，p：0.03）成为短期生存的显著独立预测因素。
心电图上fQRS的存在作为心肌纤维化的间接指标，似乎有可能被用作TAVI术后的预后标志物。有必要开展大型前瞻性研究。
