左心室非压实患者V1导联P波末端力异常与不良心脏重构相关：一种有用的疾病严重程度的无创指标

IF 1.3 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of electrocardiology Pub Date : 2025-03-17 DOI:10.1016/j.jelectrocard.2025.153923

Huaibing Cheng MD , Yangfei Xu MM , Minjie Lu MD , Gang Yin MS , Fang Liu MM , Wenxuan Zhai MM , Jia He MM , Lan Wang MB , Chunfang Wang MM , Hailan Chen MB , Shihua Zhao MD , Xiaohan Fan MD

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引用次数: 0

摘要

背景：V1导联P波末端力异常（PTFV1）与多种心血管疾病的不良结局有关。然而，PTFV1在左心室不压实（LVNC）患者中的潜在作用尚未报道。因此，本研究旨在探讨PTFV1在LVNC患者中的患病率，并探讨其与左心房（LA）和左心室（LV）异常的可能关联。方法2016年1月至2017年12月，通过心血管磁共振（CMR）诊断为LVNC的患者93例纳入研究。回顾性收集临床、超声心动图、CMR和心电图资料并独立分析。结果93例患者确诊时平均年龄为44.3±13.9岁，男性占64.5%。23.6%的患者存在PTFV1异常。PTFV1异常的患者NYHA功能III级或IV级的发生率明显更高(86.4% vs. 19.7%, p <；0.001)，左室血栓（9.0%比4.2%,p = 0.049）和晚期钆增强（63.6%比33.8%,p = 0.013）。这些患者的二尖瓣返流等级明显更高，左室和左室容积指数更大，左室射血分数（LVEF）更低。受试者工作特征曲线分析显示，各指标识别PTFV1异常的曲线下面积（AUC）值为中高，范围为0.72 ~ 0.83，其中LVEF的AUC最高，为0.83。二元logistic回归发现LVEF是唯一与PTFV1异常相关的独立因素（OR = 0.89, p = 0.003）。结论在大约四分之一的LVNC患者中观察到PTFV1异常与更严重的心脏重构和功能障碍有关，其存在可以通过LVEF降低来预测。

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Abnormal P wave terminal force in lead V1 is correlated with adverse cardiac remodeling in patients with left ventricular noncompaction: A useful noninvasive indicator of disease severity

Background

Abnormal P wave terminal force in lead V1 (PTFV1) has been associated with adverse outcomes in various cardiovascular conditions. However, the potential role of PTFV1 in patients with left ventricular noncompaction (LVNC) has not been reported. Therefore, this study aims to investigate the prevalence of PTFV1 in patients with LVNC and explore its possible association with abnormalities in both the left atrium (LA) and left ventricle (LV).

Methods

From January 2016 to December 2017, 93 patients diagnosed with LVNC via cardiovascular magnetic resonance (CMR) were enrolled in the study. Clinical, echocardiographic, CMR, and electrocardiogram data were retrospectively collected and analyzed independently.

Results

The mean age of the 93 patients at diagnosis was 44.3 ± 13.9 years, with 64.5 % being male. Abnormal PTFV1 was present in 23.6 % of the patients. Those with abnormal PTFV1 had significantly higher rates of NYHA functional class III or IV (86.4 % vs. 19.7 %, p < 0.001), LV thrombus (9.0 % vs. 4.2 %, p = 0.049), and late gadolinium enhancement (63.6 % vs. 33.8 %, p = 0.013). These patients also had significantly greater mitral regurgitation grades, larger LA and LV volume indices, and lower LV ejection fraction (LVEF). Receiver operating characteristic curve analysis showed moderate-to-high area under the curve (AUC) values (ranging from 0.72 to 0.83) for various indices in identifying abnormal PTFV1, with LVEF showing the highest AUC of 0.83. Binary logistic regression identified LVEF as the only independent factor associated with abnormal PTFV1 (OR = 0.89, p = 0.003).

Conclusion

Abnormal PTFV1, observed in approximately one-quarter of LVNC patients, is linked to more severe cardiac remodeling and dysfunction, and its presence can be predicted by a reduced LVEF.

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来源期刊

Journal of electrocardiology 医学-心血管系统

CiteScore

2.70

自引率

7.70%

发文量

152

审稿时长

38 days

期刊介绍： The Journal of Electrocardiology is devoted exclusively to clinical and experimental studies of the electrical activities of the heart. It seeks to contribute significantly to the accuracy of diagnosis and prognosis and the effective treatment, prevention, or delay of heart disease. Editorial contents include electrocardiography, vectorcardiography, arrhythmias, membrane action potential, cardiac pacing, monitoring defibrillation, instrumentation, drug effects, and computer applications.