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塞尔维斯特 QRS 评分是射血分数保留型心力衰竭患者死亡率的预测指标。

Selvester QRS Score is a Predictor of Mortality in Heart Failure with Preserved Ejection Fraction.

机构信息

Nazilli State Hospital - Department of Cardiology, Aydin - Turquia.

Adana Health Practice and Research Center - Department of Cardiology, Adana - Turquia.

出版信息

Arq Bras Cardiol. 2023 Oct 9;120(9):e20230235. doi: 10.36660/abc.20230235. eCollection 2023.

Abstract

BACKGROUND

The Selvester QRS (S-QRS) score on a 12-lead electrocardiogram (ECG) is associated with both the amount of myocardial scar and poor prognosis in myocardial infarction patients. However, its prognostic value in heart failure (HF) with preserved ejection fraction (HFpEF) is unknown.

OBJECTIVE

This study aims to investigate the predictive value of the S-QRS score for mortality in HFpEF.

METHODS

359 patients were retrospectively enrolled in this study. Electrocardiographic, echocardiographic, and laboratory features of the patients were recorded. The simplified S-QRS score was measured and recorded. The mean follow-up time of the patients was 38.1±9.5 months. Statistical significance was set at p < 0.05.

RESULTS

Of 359 patients, 270 were in the survivor group, and 89 were in the deceased group. Age, Hs-CRP, troponin, pro-BNP, left atrial (LA) diameter, LA volume index, QRS duration, Tpe, and S-QRS score were statistically high in the deceased group. In multivariate logistic regression analysis, age, Hs-CRP, NT-proBNP, LA diameter, LA volume index, Tpe, and S-QRS score were shown to be independent risk factors for mortality. In the receiver-operating characteristic (ROC) analysis, the cut-off value of the S-QRS score was 5.5, the sensitivity was 80.8%, and the specificity was 77.2% (AUC:0.880, p:0.00). In Kaplan-Meier analysis, it was found that mortality was higher in the group with S-QRS score ≥ 5.5 than in the group with S-QRS score < 5.5. (Long-rank, p:0.00).

CONCLUSIONS

We think that the S-QRS score can be used as a prognostic indicator of long-term mortality in patients with HFpEF.

摘要

背景

12 导联心电图(ECG)上的 Selvester QRS(S-QRS)评分与心肌梗死患者的心肌瘢痕量和预后不良相关。然而,其在射血分数保留的心力衰竭(HFpEF)中的预后价值尚不清楚。

目的

本研究旨在探讨 S-QRS 评分对 HFpEF 患者死亡率的预测价值。

方法

回顾性纳入 359 例患者,记录患者的心电图、超声心动图和实验室特征。测量并记录简化的 S-QRS 评分。患者的平均随访时间为 38.1±9.5 个月。统计学意义设为 p<0.05。

结果

359 例患者中,270 例存活,89 例死亡。死亡组年龄、超敏 C 反应蛋白(Hs-CRP)、肌钙蛋白、脑钠肽前体(pro-BNP)、左心房(LA)直径、LA 容积指数、QRS 持续时间、Tpe 和 S-QRS 评分均较高。多变量逻辑回归分析显示,年龄、Hs-CRP、NT-proBNP、LA 直径、LA 容积指数、Tpe 和 S-QRS 评分是死亡的独立危险因素。在受试者工作特征(ROC)分析中,S-QRS 评分的截断值为 5.5,敏感性为 80.8%,特异性为 77.2%(AUC:0.880,p:0.00)。在 Kaplan-Meier 分析中,发现 S-QRS 评分≥5.5 组的死亡率高于 S-QRS 评分<5.5 组(Long-rank,p:0.00)。

结论

我们认为 S-QRS 评分可作为 HFpEF 患者长期死亡率的预后指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f65/10519357/22fd234a77e3/0066-782X-abc-120-09-e20230235-gf01.jpg

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