Impact of potentially lethal ventricular arrhythmias on long-term outcome in patients with chronic heart failure

作     者：Liu Ye-hong Su Jing-ying Wang Lin-jie Li Jin-ping Zhou Qing-fen Gan Qian Chai Xi-chen Dai Li-ying Zhang Feng-ru Shen Wei-feng 

作者机构：Shanghai Jiao Tong Univ Sch Med Ruijin Hosp Dept Cardiol Shanghai 200025 Peoples R China Shanghai Jiao Tong Univ Sch Med Ruijin Hosp Dept Geriatr Shanghai 200025 Peoples R China Ctr Hosp Minhang Dist Dept Cardiol Shanghai 201100 Peoples R China 

出 版 物：《Chinese Medical Journal》 (中华医学杂志（英文版）)

年 卷 期：2012年第000卷第4期

页      面：563-568页

核心收录：

学科分类：0831[工学-生物医学工程（可授工学、理学、医学学位）] 080202[工学-机械电子工程] 08[工学] 0802[工学-机械工程] 

基　　金：This work was supported by a grant from the Shanghai Science and Technology Foundation (No.09PJ1407400) 

主　　题：chronic heart failure arrhythmia outcome electrocardiography 

摘      要：Background Potentially lethal ventricular arrhythmias （PLVAs） occur frequently in survivors after acute myocardial infarction and are increasingly recognized in other forms of structural heart *** study investigated the prevalence and prognostic significance of PLVAs in patients with chronic heart failure （CHF）.Methods Data concerning demographics,etiology of heart failure,NYHA functional class,biochemical variables,electrocardiographic and echocardiographic findings,and medical treatments were collected by reviewing hospital medical records from 1080 patients with NYHA Ⅱ-Ⅳ and a left ventricular （LV） ejection fraction ≤45%.PLVAs were defined as multi-focal ventricular ectopy （〉30 beats/h on Holter monitoring）,bursts of ventricular premature beats,and nonsustained ventricular ***-cause mortality,sudden death,and rehospitalization due to worsening heart failure,or cardiac transplantation during 5-year follow-up after discharge were *** The occurrence rate of PLVAs in CHF was 30.2%,and increased with age; 23.4% in patients 〈45 years old,27.8% in those between 45-65 years old,and 33.5% in patients 〉65 years old （P=0.033）.Patients with PLVAs had larger LV size and lower ejection fraction （both P 〈0.01） and higher all-cause mortality （P=0.014） during 5-year follow-up than those without *** （OR 1.041,95% Cl 1.004-1.079,P=0.03） and LV end-diastolic dimension （OR 1.068,95% Cl 1.013-1.126,P=0.015） independently predicted the occurrence of *** PLVA was an independent factor for all-cause mortality （RR 1.702,95% Cl 1.017-2.848,P=0.031） and sudden death （RR 1.937,95% CI 1.068-3.516,P=0.030） in patients with *** PLVAs are common and exert a negative impact on Iona-term clinical outcome in patients with CHF.