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堪萨斯城心肌病问卷与心电图参数在预测心脏再同步治疗后结局中的关系

The Relationship Between the Kansas City Cardiomyopathy Questionnaire and Electrocardiographic Parameters in Predicting Outcomes After Cardiac Resynchronization Therapy.

作者信息

Rosu Andrei-Mihnea, Tomescu Luminita-Florentina, Badea Theodor-Georgian, Radu Emanuel-Stefan, Rosu Andreea-Liana, Brezeanu Lavinia-Nicoleta, Tanasescu Maria-Daniela, Isac Sebastian, Isac Teodora, Popa Oana-Andreea, Sinescu Crina-Julieta

机构信息

Department of Cardiology, Prof. Dr. Agrippa Ionescu Emergency Hospital, Balotesti, 077015 Ilfov, Romania.

Doctoral School, Carol Davila University of Medicine and Pharmacy, 022328 Bucharest, Romania.

出版信息

Life (Basel). 2024 Nov 28;14(12):1564. doi: 10.3390/life14121564.

DOI:10.3390/life14121564
PMID:39768272
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11679991/
Abstract

BACKGROUND

Cardiac resynchronization therapy (CRT) is an essential treatment for patients with symptomatic heart failure and ventricular conduction abnormalities. Low-ejection-fraction (EF) cardiomyopathy often involves a wide QRS complex displaying a left bundle branch block (LBBB) morphology and markedly delayed activation of the LV lateral wall. Following CRT, patients with heart failure and LBBB have better outcomes and quality-of-life improvements. Various electrocardiographic and clinical parameters are thought to be able to predict this improvement. The Kansas City Cardiomyopathy Questionnaire (KCCQ) is a reliable tool for measuring these patients' quality of life.

METHODS

This is an observational prospective study featuring over 69 individuals diagnosed with cardiac failure and dilatative cardiomyopathy with low-EF and major LBBB. This study analyzed the correlations between patient outcomes and demographic, clinical, and electrocardiographic parameters.

RESULTS

Following the analysis, we observed correlations between the QRS area, intraprocedural systolic blood pressure, Q-LV interval, the R-wave amplitude in the right precordial leads and the CRT outcomes indicated by the KCCQ score.

CONCLUSIONS

The parameters found and their correlation with the KCCQ score show how CRT therapy impacts patients' quality of life, symptom burden, and functional status.

摘要

背景

心脏再同步治疗（CRT）是有症状心力衰竭和心室传导异常患者的重要治疗方法。低射血分数（EF）心肌病常伴有宽QRS波群，呈左束支传导阻滞（LBBB）形态，左室侧壁激活明显延迟。CRT治疗后，心力衰竭合并LBBB的患者有更好的预后和生活质量改善。各种心电图和临床参数被认为能够预测这种改善情况。堪萨斯城心肌病问卷（KCCQ）是衡量这些患者生活质量的可靠工具。

方法

这是一项观察性前瞻性研究，纳入了69例以上诊断为心力衰竭、低EF值和严重LBBB的扩张型心肌病患者。本研究分析了患者预后与人口统计学、临床和心电图参数之间的相关性。

结果

分析后，我们观察到QRS面积、术中收缩压、Q-LV间期、右胸前导联R波振幅与KCCQ评分所示的CRT预后之间存在相关性。

结论

所发现的参数及其与KCCQ评分的相关性表明了CRT治疗对患者生活质量、症状负担和功能状态的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d09/11679991/b2113d08ca58/life-14-01564-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d09/11679991/47eab62800f8/life-14-01564-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d09/11679991/e5202d34229c/life-14-01564-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d09/11679991/6b20a6046b6e/life-14-01564-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d09/11679991/896468015591/life-14-01564-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d09/11679991/b2113d08ca58/life-14-01564-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d09/11679991/47eab62800f8/life-14-01564-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d09/11679991/e5202d34229c/life-14-01564-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d09/11679991/6b20a6046b6e/life-14-01564-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d09/11679991/896468015591/life-14-01564-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d09/11679991/b2113d08ca58/life-14-01564-g005.jpg

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J Card Fail. 2025 Feb;31(2):481-484. doi: 10.1016/j.cardfail.2024.08.061. Epub 2024 Sep 28.
2
Exploring QRS Area beyond Patient Selection in CRT-Can It Guide Left Ventricular Lead Placement?在心脏再同步治疗中探索除患者选择之外的QRS波面积——它能指导左心室导线放置吗？
J Cardiovasc Dev Dis. 2024 Jan 11;11(1):18. doi: 10.3390/jcdd11010018.
3
New York Heart Association Class and Kansas City Cardiomyopathy Questionnaire in Acute Heart Failure.
纽约心脏协会心功能分级和堪萨斯城心肌病问卷在急性心力衰竭中的应用。
JAMA Netw Open. 2023 Oct 2;6(10):e2339458. doi: 10.1001/jamanetworkopen.2023.39458.
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Significance of effective cardiac resynchronization therapy pacing for clinical responses: An analysis based on the effective cardiac resynchronization therapy algorithm.有效心脏再同步治疗起搏对临床反应的意义：基于有效心脏再同步治疗算法的分析。
Heart Rhythm. 2023 Sep;20(9):1289-1296. doi: 10.1016/j.hrthm.2023.06.005. Epub 2023 Jun 10.
5
Does targeted positioning of the left ventricular pacing lead towards the latest local electrical activation in cardiac resynchronization therapy reduce the incidence of death or hospitalization for heart failure?心脏再同步治疗中，将左心室起搏导线靶向定位于最新的局部电激活位置是否能降低心力衰竭死亡或住院的发生率？
Am Heart J. 2023 Sep;263:112-122. doi: 10.1016/j.ahj.2023.05.011. Epub 2023 May 21.
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Physiologic Pacing Targeting the His Bundle and Left Bundle Branch: a Review of the Literature.生理性希氏束及左束支起搏：文献复习。
Curr Cardiol Rep. 2022 Aug;24(8):959-978. doi: 10.1007/s11886-022-01723-3. Epub 2022 Jun 9.
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