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射血分数降低的心力衰竭患者植入式心律转复除颤器(ICD)中MVP心电图风险评分预测长期心房颤动的效率

Efficiency of MVP ECG Risk Score for Prediction of Long-Term Atrial Fibrillation in Patients With ICD for Heart Failure With Reduced Ejection Fraction.

作者信息

Pay Levent, Yumurtaş Ahmet Çağdaş, Tezen Ozan, Çetin Tuğba, Eren Semih, Çinier Göksel, Hayıroğlu Mert İlker, Tekkeşin Ahmet İlker

机构信息

Department of Cardiac, Ardahan State Hospital, Ardahan, Turkey.

Department of Cardiology, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training Hospital, İstanbul, Turkey.

出版信息

Korean Circ J. 2023 Sep;53(9):621-631. doi: 10.4070/kcj.2022.0353. Epub 2023 Jun 9.

Abstract

BACKGROUND AND OBJECTIVES

The morphology-voltage-P-wave duration (MVP) electrocardiography (ECG) risk score is a newly defined scoring system that has recently been used for atrial fibrillation (AF) prediction. The aim of this study was to evaluate the ability of the MVP ECG risk score to predict AF in patients with an implantable cardioverter defibrillator (ICD) and heart failure with reduced ejection fraction in long-term follow-up.

METHODS

The study used a single-center, and retrospective design. The study included 328 patients who underwent ICD implantation in our hospital between January 2010 and April 2021, diagnosed with heart failure. The patients were divided into low, intermediate and high-risk categories according to the MVP ECG risk scores. The long-term development of atrial fibrillation was compared among these 3 groups.

RESULTS

The low-risk group included 191 patients, the intermediate-risk group 114 patients, and the high-risk group 23 patients. The long-term AF development rate was 12.0% in the low-risk group, 21.9% in the intermediate risk group, and 78.3% in the high-risk group. Patients in the high-risk group were found to have 5.2 times higher rates of long-term AF occurrence compared to low-risk group.

CONCLUSIONS

The MVP ECG risk score, which is an inexpensive, simple and easily accessible tool, was found to be a significant predictor of the development of AF in the long-term follow-up of patients with an ICD with heart failure with reduced ejection fraction. This risk score may be used to identify patients who require close follow-up for development and management of AF.

摘要

背景与目的

形态学-电压-P波时限(MVP)心电图(ECG)风险评分是一种新定义的评分系统,最近已用于预测心房颤动(AF)。本研究的目的是评估MVP心电图风险评分在长期随访中预测植入式心脏复律除颤器(ICD)和射血分数降低的心力衰竭患者发生AF的能力。

方法

本研究采用单中心回顾性设计。研究纳入了2010年1月至2021年4月在我院接受ICD植入且诊断为心力衰竭的328例患者。根据MVP心电图风险评分将患者分为低、中、高风险类别。比较这三组患者心房颤动的长期发展情况。

结果

低风险组包括191例患者,中风险组114例患者,高风险组23例患者。低风险组的长期AF发生率为12.0%,中风险组为21.9%,高风险组为78.3%。发现高风险组患者长期AF发生几率是低风险组的5.2倍。

结论

MVP心电图风险评分是一种廉价、简单且易于获取的工具,在射血分数降低的心力衰竭且植入ICD的患者长期随访中,它是AF发生的重要预测指标。该风险评分可用于识别需要密切随访以监测AF发生和进行管理的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/da92/10475693/dcd88b03e80d/kcj-53-621-g001.jpg

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