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室性早搏诱发心肌病及消融术后左心室收缩功能障碍可逆性的危险因素:观察性研究的系统评价和荟萃分析

Risk Factors for PVC Induced Cardiomyopathy and Post-Ablation Left Ventricular Systolic Dysfunction Reversibility: A Systematic Review and Meta-Analysis of Observational Studies.

作者信息

Zhao Dongsheng, Chen Qiushi, Zhou Zhongyin, Zhao Pengcheng, Shi Jianzhou, Yin Jun, Zhang Qing, Zhang Fengxiang

机构信息

Department of Cardiology, The Second Affiliated Hospital of Nantong University, 226001 Nantong, Jiangsu, China.

Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 210029 Nanjing, Jiangsu, China.

出版信息

Rev Cardiovasc Med. 2024 Sep 11;25(9):327. doi: 10.31083/j.rcm2509327. eCollection 2024 Sep.

Abstract

BACKGROUND

Premature ventricular complex (PVC) induced cardiomyopathy (PVC-CMP) and exacerbated left ventricular systolic dysfunction (LVSD) are common in clinical scenarios. However, their precise risk factors are currently unclear.

METHODS

We performed a systematic review of PubMed, EMBASE, Web of Science, and Chinese-based literature database (CBM) to identify observational studies describing the factors associated with PVC-CMP and post-ablation LVSD reversibility. A total of 25 and 12 studies, involving 4863 and 884 subjects, respectively, were eligible. We calculated pooled multifactorial odds ratios (OR) and 95% confidence intervals (CI) for each parameter using random-effects and fixed-effects models.

RESULTS

The results showed that 3 independent risk factors were associated with PVC-CMP: being asymptomatic (OR and 95% CI: 3.04 [2.13, 4.34]), interpolation (OR and 95% CI: 2.47 [1.25, 4.92]), and epicardial origin (epi-origin) (OR and 95% CI: 3.04 [2.13, 4.34]). Additionally, 2 factors were significantly correlated with post-ablation LVSD reversibility: sinus QRS wave duration (QRSd) (OR and 95% CI: 0.95 [0.93, 0.97]) and PVC burden (OR and 95% CI: 1.09 [0.97, 1.23]).

CONCLUSIONS

the relatively consistent independent risk factors for PVC-CMP and post-ablation LVSD reversibility are asymptomatic status, interpolation, epicardial origin, PVC burden, and sinus QRS duration, respectively.

摘要

背景

室性早搏(PVC)诱发的心肌病(PVC-CMP)和左心室收缩功能障碍(LVSD)加重在临床中很常见。然而,其确切的危险因素目前尚不清楚。

方法

我们对PubMed、EMBASE、Web of Science和中国生物医学文献数据库(CBM)进行了系统综述,以确定描述与PVC-CMP和消融后LVSD可逆性相关因素的观察性研究。分别有25项和12项研究符合条件,涉及4863名和884名受试者。我们使用随机效应和固定效应模型计算每个参数的合并多因素比值比(OR)和95%置信区间(CI)。

结果

结果显示,与PVC-CMP相关的3个独立危险因素为:无症状(OR和95%CI:3.04[2.13,4.34])、插入型(OR和95%CI:2.47[1.25,4.92])和心外膜起源(心外膜起源)(OR和95%CI:3.04[2.13,4.34])。此外,2个因素与消融后LVSD可逆性显著相关:窦性QRS波时限(QRSd)(OR和95%CI:0.95[0.93,0.97])和PVC负荷(OR和95%CI:1.09[0.97,1.23])。

结论

PVC-CMP和消融后LVSD可逆性相对一致的独立危险因素分别为无症状状态、插入型、心外膜起源、PVC负荷和窦性QRS时限。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/813f/11440414/eeed116f36d7/2153-8174-25-9-327-g1.jpg

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