完全性左束支阻滞患者左室射血分数恶化的临床决定因素。

IF 0.4 4区 医学
Iranian Red Crescent Medical Journal Pub Date : 2015-02-21 eCollection Date: 2015-02-01 DOI:10.5812/ircmj.16570
Mohammad Hashemi Jazi, Peyman Nilforoush, Mojgan Gharipour, Azadeh Batvandi, Robabeh Mohammadi, Roya Najafi
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引用次数: 5

摘要

背景:近年来,人们开始关注左束支阻滞(LBBB)对左心室收缩功能的不良影响。目的:本研究旨在确定预测完全性LBBB患者左室射血分数(LVEF)恶化的潜在因素。患者和方法:在一项回顾性病例对照研究中,评估了220例连续诊断为LBBB的患者的心电图数据。他们于2013年被转诊到伊朗伊斯法罕省的伊斯法罕心脏中心。LVEF恶化被定义为LVEF在基线和随访超声心动图研究之间至少下降10%。因此,对于初始EF > 50%的患者,达到LVEF值≤40%被认为是LVEF恶化。结果:在220例患者中,40%的LBBB患者在初始评估的3个月内出现LVEF恶化。LVEF恶化组男女比例高,NYHA评分高,收缩期高血压发生率高于对照组。冠心病患者的LVEF也明显低于非冠心病患者。收缩压与LVEF (r = -0.193, P = 0.006)、NYHA评分与LVEF (r = -0.215, P = 0.002)存在不良相关。多变量logistic回归模型显示,在基线变量中,男性(OR = 3.218, P < 0.001)、收缩期高血压史(OR = 2.012, P = 0.029)、较高的NYHA评分(OR = 1.623, P = 0.005)、是否存在冠状动脉疾病(OR = 2.475, P = 0.028)可有效预测LBBB患者LVEF恶化。结论:男性、高血压史、高NYHA评分和存在CAD可预测LBBB患者LVEF恶化。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Clinical determinants of left ventricular ejection fraction deterioration in patients suffered from complete left bundle branch block.

Clinical determinants of left ventricular ejection fraction deterioration in patients suffered from complete left bundle branch block.

Background: Recently, the deleterious effects of left bundle branch block (LBBB) on left ventricular systolic function have been taken into consideration.

Objectives: The present study aimed to identify underlying factors that predict left ventricular ejection fraction (LVEF) deterioration in patients suffered from complete LBBB.

Patients and methods: In a retrospective case-control study, the data of 220 consecutive patients diagnosed with LBBB on their electrocardiograms were assessed. They were referred to Isfahan Heart Center in Isfahan Province, Iran in 2013. LVEF deterioration was defined as a decrease in LVEF at least 10% between the baseline and follow-up echocardiography study. Thus, achieving the LVEF values ≤ 40% in patients with an initial EF of > 50% was considered LVEF deterioration.

Results: Among 220 patients, 40% of LBBB patients suffered LVEF deterioration within 3 months of initial assessment. The group with LVEF deterioration had higher male to female ratio, had higher NYHA score, and suffered more from systolic hypertension than another group. Those with coronary artery disease (CAD) had also significantly lower LVEF than non-CAD ones. Adverse associations were revealed between systolic blood pressure and LVEF measurement (r = -0.193, P = 0.006) as well as between NYHA score and LVEF (r = -0.215, P = 0.002). A multivariable logistic regression model showed that among baseline variables, male gender (OR = 3.218, P < 0.001), history of systolic hypertension (OR = 2.012, P = 0.029), higher NYHA score (OR = 1.623, P = 0.005), and the presence of coronary artery disease (OR = 2.475, P = 0.028) could effectively predict LVEF deterioration in patients with LBBB.

Conclusions: Male gender, history of hypertension, high NYHA score, and the presence of CAD predict LVEF deterioration in patients with LBBB.

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来源期刊
Iranian Red Crescent Medical Journal
Iranian Red Crescent Medical Journal 医学-医学:内科
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期刊介绍: The IRANIAN RED CRESCENT MEDICAL JOURNAL is an international, English language, peer-reviewed journal dealing with general Medicine and Surgery, Disaster Medicine and Health Policy. It is an official Journal of the Iranian Hospital Dubai and is published monthly. The Iranian Red Crescent Medical Journal aims at publishing the high quality materials, both clinical and scientific, on all aspects of Medicine and Surgery
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