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JAHA:致心律失常右心室心肌病患者不良心力衰竭结局新风险预测模型

2022-07-01 MedSci原创 MedSci原创

该研究已经开发出了新的心律失常性右心室心肌病的风险预测模型,可以识别有终末期心衰事件风险的患者,并可能指导医生评估个体化的心衰风险和优化治疗策略。

心律失常性右心室心肌病是一种以右心室(RV)心肌纤维脂肪替代为特征的遗传性疾病,主要由桥粒体基因突变所致。患者从早期就有危及生命的室性心动过速的风险,但在疾病的后期也可能发生进行性心力衰竭(HF)。不同于常见的心肌疾病,如扩张型心肌病,主要表现为左室(LV)功能障碍,致心律失常性右心室心肌病常引起右室功能障碍,后可能发展为双室心力衰竭。

近日,心血管疾病领域权威杂志JAHA上发表了一篇研究文章,该研究旨在描述潜在的风险预测因素,并建立一种用于致心律失常性右心室心肌病结局个体化评估的模型。

研究人员对来自中国北京阜外医院的290例致心律失常性右心室心肌病患者和来自瑞士苏黎世大学心脏中心的99例患者进行了随访数据的纵向观察队列研究。该研究的主要终点是心脏移植或心力衰竭所致死亡。

该模型由Cox回归分析开发,用于预测风险,并经内部验证。在4.92±3.03年的随访期间,48例患者出现了主要终点。风险预测模型的决定因素包括左心室射血分数、血清肌酐水平、中度至重度三尖瓣反流和房颤。植入心律转复除颤器不能减少HF不良结局的发生。

由此可见,该研究已经开发出了新的心律失常性右心室心肌病的风险预测模型,该模型使用了两个大型的队列,并纳入了常见的临床参数,如左心室射血分数、血清肌酐水平、三尖瓣反流和房颤,可以识别有终末期心衰事件风险的患者,并可能指导医生评估个体化的心衰风险和优化治疗策略。

原始出处:

Shi Chen.et al.Novel Risk Prediction Model to Determine Adverse Heart Failure Outcomes in Arrhythmogenic Right Ventricular Cardiomyopathy.JAHA.2022.https://www.ahajournals.org/doi/10.1161/JAHA.121.024634

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    2022-07-03 zhaohui6731
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