Lu L, Zhong J, Wu X, Chen Q, Lin H, Chen L, Luo Y
Department of Cardiology, Fujian Medical University Union Hospital, Fuzhou 350001, China.
Fujian Heart Medical Center, Fuzhou 350001, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2023 Mar 20;43(3):400-404. doi: 10.12122/j.issn.1673-4254.2023.03.09.
To analyze the association of resting heart rate (RHR) with the prognosis of patients with post-infarction ventricular aneurysms.
We retrospectively analyzed the clinical data of 227 patients with post-infarction ventricular aneurysms admitted to our hospital during 2017-2019. The endpoint event was the occurrence of any major adverse cardiovascular and cerebrovascular events (MACCEs) during the follow-up for 24 months. According to RHR measurements, the patients were divided into 3 groups with baseline RHR < 10%, 10%-90%, and >90%. The Cox proportional risk model and restricted cubic spline (RCS) model were used to analyze the effect of RHR on MACCEs.
During the 24-month followup, 90 patients (39.6%) experienced MACCEs. The fully adjusted RCS curves showed a nonlinear "U" shaped correlation between RHR and the occurrence of MACCEs. In the fully adjusted model, the risk of MACCEs increased by 3.01-fold (Hazard ratio [HR]=4.01, 95% : 2.07-7.76, < 0.001) in patients with RHR>90%, as compared with patients with RHR of 10%-90%. In patients with RHR in 1-9th percentile, 10th-90th percentile and 91st-100th percentile, the incidences of MACCEs were 39.1%, 36.6% and 66.7% (=0.027), the incidences of ventricular tachycardia/ventricular fibrillation (VT/VF) were 17.4%, 2.7% and 4.8% (=0.005), and the incidences of readmission for heart failure were 8.7%, 26.8% and 42.9% (=0.036), respectively.
Continuous monitoring and management of heart rate range may provide guidance for prognosis prediction in patients with post-infarction ventricular aneurysms.
分析静息心率（RHR）与心肌梗死后室壁瘤患者预后的相关性。
回顾性分析2017年至2019年我院收治的227例心肌梗死后室壁瘤患者的临床资料。终点事件为随访24个月期间发生的任何主要不良心血管和脑血管事件（MACCEs）。根据RHR测量值，将患者分为3组，基线RHR<10%、10%-90%和>90%。采用Cox比例风险模型和受限立方样条（RCS）模型分析RHR对MACCEs的影响。
在24个月的随访期间，90例患者（39.6%）发生了MACCEs。完全调整后的RCS曲线显示RHR与MACCEs的发生之间呈非线性“U”形相关性。在完全调整模型中，与RHR为10%-90%的患者相比，RHR>90%的患者发生MACCEs的风险增加3.01倍（风险比[HR]=4.01，95%：2.07-7.76，<0.001）。RHR处于第1-9百分位数、第10-90百分位数和第91-100百分位数的患者，MACCEs的发生率分别为39.1%、36.6%和66.7%（P=0.027），室性心动过速/心室颤动（VT/VF）的发生率分别为17.4%、2.7%和4.8%（P=0.005），因心力衰竭再次入院的发生率分别为8.7%、26.8%和42.9%（P=0.036）。
持续监测和管理心率范围可为心肌梗死后室壁瘤患者的预后预测提供指导。
