JACC:新模型可预测急性MI后严重左心室收缩功能不全的患者射血分数恢复

2016-03-09 崔倩 译 MedSci原创

心肌梗死(MI)后持续严重左心室(LV)收缩功能障碍与死亡率增加有关,是心脏除颤器植入的I类指标。本研究建立了模型,评估了急性心肌梗死和严重左心室功能障碍患者90天随访后评估LV恢复>35%,≥50%的独立预测因子。该多中心前瞻性观察研究纳入了在MI期间射血分数(EF)≤35%的患者(n=231)。EF恢复到>35%和≥50%的预测因子通过多元建模后确定,并在一个单独的队列(n=236

心肌梗死(MI)后持续严重左心室(LV)收缩功能障碍与死亡率增加有关,是心脏除颤器植入的I类指标。

本研究建立了模型,评估了急性心肌梗死和严重左心室功能障碍患者90天随访后,LV恢复>35%、≥50%的独立预测因子。

该多中心前瞻性观察研究纳入了在MI期间射血分数(EF)≤35%的患者(n=231)。EF恢复到>35%和≥50%的预测因子通过多元建模后确定,并在一个单独的队列(n=236)中验证。

在PREDICTS研究中,43%的患者有持续的EF≤35%,31%的患者EF为36%到49%,26%的患者EF≥50%。预测EF恢复到>35%的模型包括就诊时EF、住院天数、既往心肌梗死病史、就诊时的横向室壁运动异常,和峰值肌钙蛋白。预测EF的恢复≥50%的最好的模型包括在就诊时EF、峰值肌钙蛋白、既往心梗病史、并在就诊时的心室颤动或心脏骤停。当预测因子转化为点分数后,最低点的分数的预测EF恢复到>35%和≥50%的概率分别9%和4%,而最高点分数预测的EF恢复到>35%和≥50%的概率分别87%和49%。

急性心肌梗死后严重收缩功能不全的患者EF≤35%,有57%的概率射血分数会恢复至>35%。在心肌梗死时使用临床时间变量的模型可以帮助预测EF恢复。

原始出处:

Gabriel C. Brooks,Byron K. Lee,Rajni Rao,et al.Predicting Persistent Left Ventricular Dysfunction Following Myocardial Infarction,JACC,2016.3.8

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    2016-08-10 hbwxf
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    2016-03-22 1de304d2m86(暂无匿称)

    学习了,好

    0

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