非持续性室性心动过速在巴西肥厚型心肌病队列中的预后价值：与世界文献的比较
Prognostic Value of Nonsustained Ventricular Tachycardia in Hypertrophic Cardiomyopathy in a Brazilian Cohort: Comparison with World Literature.
作者信息
Silva Diego Araújo, Arteaga-Fernandez Edmundo, Hotta Viviane Tiemi, Mady Charles, Ianni Barbara, Ramires Felix, Nastari Luciano, Fernandes Fábio, Cardoso Juliano Novaes
机构信息
Faculdade Santa Marcelina Curso de Medicina, São Paulo, SP - Brasil.
Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brasil.
出版信息
Arq Bras Cardiol. 2025 Apr;122(5):e20240399. doi: 10.36660/abc.20240399.
BACKGROUND
In hypertrophic cardiomyopathy (HCM), there is a well-known association between nonsustained ventricular tachycardia (NSVT) and the risk of sudden death.
OBJECTIVES
To assess the incidence of NSVT using 24-hour Holter monitoring in patients with HCM in a Brazilian cohort and correlate it with its characteristics and progression.
METHODS
This retrospective study of patients with HCM used 24-hour Holter monitoring to assess the presence of long-lasting, fast NSVT (≥ 10 beats and heart rate ≥ 130 bpm) or the presence of at least 3 episodes of NSVT with ≥ 3 beats and heart rate ≥ 120 bpm. Continuous variables were shown as arithmetic means and standard deviations, and categorical variables were shown as absolute and relative frequencies. P < 0.05 was considered significant.
RESULTS
We included 763 patients, 53.5% of whom were male. Their mean age was 52.6 years ± 16.7. NSVT was found in 10% (76 patients). Only 11 (1.4%) of them had NSVT with ≥ 10 beats and heart rate ≥ 130 bpm. There was no difference in the relationship between NSVT and sex, septum > 30 mm, age ≥ 40 years, betablocker dose, and presence of atrial fibrillation. In the group with NSVT, 15-year all-cause mortality was observed in 26.3%, compared to 15.9% in the group without NSVT (p = 0.021).
CONCLUSIONS
The presence of NSVT on 24-hour Holter monitoring occurred in 10% of patients. Long-lasting, fast NSVT was rare. The presence of NSVT was associated with higher overall mortality during follow-up.
背景
在肥厚型心肌病（HCM）中，非持续性室性心动过速（NSVT）与猝死风险之间存在众所周知的关联。
目的
在巴西队列中，使用24小时动态心电图监测评估HCM患者中NSVT的发生率，并将其与特征及病情进展相关联。
方法
这项针对HCM患者的回顾性研究采用24小时动态心电图监测，以评估持续性快速NSVT（≥10次心跳且心率≥130次/分钟）的存在情况，或至少3次发作的NSVT（≥3次心跳且心率≥120次/分钟）的存在情况。连续变量以算术平均值和标准差表示，分类变量以绝对和相对频率表示。P<0.05被认为具有统计学意义。
结果
我们纳入了763例患者，其中53.5%为男性。他们的平均年龄为52.6岁±16.7岁。发现10%（76例）患者存在NSVT。其中只有11例（1.4%）患者的NSVT为≥10次心跳且心率≥130次/分钟。NSVT与性别、室间隔>30mm、年龄≥40岁、β受体阻滞剂剂量以及房颤的存在之间的关系无差异。在有NSVT的组中，观察到15年全因死亡率为26.3%，而无NSVT的组为15.9%（p=0.021）。
结论
24小时动态心电图监测显示10%的患者存在NSVT。持续性快速NSVT很少见。NSVT的存在与随访期间较高的总体死亡率相关。
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