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失代偿性心力衰竭患者的心电图及其他无创血流动力学标志物

Electrocardiographic and other Noninvasive Hemodynamic Markers in Decompensated CHF Patients.

作者信息

Piccirillo Gianfranco, Moscucci Federica, Mezzadri Martina, Caltabiano Cristina, Di Diego Ilaria, Carnovale Myriam, Corrao Andrea, Stefano Sara, Scinicariello Claudia, Giuffrè Marco, De Santis Valerio, Sciomer Susanna, Rossi Pietro, Magrì Damiano

机构信息

Department of Clinical and Internal Medicine and Anesthsiological and Cardiovascular Sciences, Policlinico Umberto I, "La Sapienza" University of Rome, 00185 Rome, Italy.

Department of Internal Medicine and Medical Specialties, Policlinico Umberto I, "La Sapienza" University of Rome, 00185 Rome, Italy.

出版信息

J Cardiovasc Dev Dis. 2023 Mar 15;10(3):125. doi: 10.3390/jcdd10030125.

Abstract

Acutely decompensated chronic heart failure (adCHF) is among the most important causes of in-hospital mortality. R-wave peak time (RT) or delayed intrinsicoid deflection was proposed as a risk marker of sudden cardiac death and heart failure decompensation. Authors want to verify if QR interval or RT, obtained from 12-lead standard ECG and during 5-min ECG recordings (II lead), could be useful to identify adCHF. At hospital admission, patients underwent 5-min ECG recordings, obtaining mean and standard deviation () of the following ECG intervals: QR, QRS, QT, JT, and T peak-T end (Te). The RT from a standard ECG was calculated. Patients were grouped by the age-stratified Januzzi NT-proBNP cut-off. A total of 140 patients with suspected adCHF were enrolled: 87 (mean age 83 ± 10, M/F 38/49) with and 53 (mean age: 83 ± 9, M/F: 23/30) without adCHF. V, V ( < 0.05) RT, and QR, QRS, QT, JT, and Te < 0.001 were significantly higher in the adCHF group. Multivariable logistic regression analysis demonstrated that the mean of QT ( < 0.05) and Te ( < 0.05) were the most reliable markers of in-hospital mortality. V RT was directly related to NT-proBNP (r: 0.26, < 0.001) and inversely related to a left ventricular ejection fraction (r: 0.38, < 0.001). The intrinsicoid deflection time (obtained from V and QR) could be used as a possible marker of adCHF.

摘要

急性失代偿性慢性心力衰竭(adCHF)是住院死亡率的最重要原因之一。R波峰时间(RT)或延迟除极时限被认为是心源性猝死和心力衰竭失代偿的风险标志物。作者想要验证从12导联标准心电图以及5分钟心电图记录(II导联)中获得的QR间期或RT是否有助于识别adCHF。入院时,患者进行5分钟心电图记录,获取以下心电图间期的平均值和标准差():QR、QRS、QT、JT以及T波峰-T波终末(Te)。计算标准心电图的RT。患者按年龄分层的Januzzi NT-proBNP临界值分组。共纳入140例疑似adCHF患者:87例(平均年龄83±10岁,男/女38/49)患有adCHF,53例(平均年龄:83±9岁,男/女:23/30)未患adCHF。adCHF组的V、V(<0.05)RT以及QR、QRS、QT、JT和Te(<0.001)显著更高。多变量逻辑回归分析表明,QT(<0.05)和Te(<0.05)的平均值是住院死亡率最可靠的标志物。V RT与NT-proBNP直接相关(r:0.26,<0.001),与左心室射血分数呈负相关(r:0.38,<0.001)。除极时限(从V和QR获得)可作为adCHF的一个可能标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/139e/10058439/af826de8ba49/jcdd-10-00125-g001.jpg

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