检索结果-南通市图书馆

世界核心医学期刊文摘（心脏病学分册） 2006年第6期2卷 15-15页

作者： Parkash R. Stevenson w.G. Epstein L.M. Maisel W.H. 宁宁 Queen Elizabeth II health Sciences Centre Halifax Infirmary Site 1796 Summer Street Halifax NS B3H 3A7 Canada Dr.

Background: Patients with advanced heart disease are at risk from sudden death; however, benefit from implantable cardioverter defibrillators(ICDs) may be limited as a result of early mortality from other causes. The objective of this study was to develop a model to predict mortality within the first year after ICD implantation. Methods and Results: A retrospective analysis was performed of 469 consecutive patients who underwent ICD implantation at a single tertiary- care center from 1999 to 2002. Vital status was determined from the Social Security Death Index. Patients were randomized into prediction and validation cohorts. A risk score was derived from the prediction cohort by multivariate logistic regression and applied to the validation cohort. One point was assigned for each variable in the risk score(age>80 years, history of atrial fibrillation, creatinine> 1.8 mg/dL,New York heart Association class III or IV). One- year mortality significantly increased with increasing risk score in both the prediction and validation cohorts. Validation cohort mortality was 3.4% for 0 points, 4.3% for 1 point, 17% for 2 points, and 33% for ≥ 3 points(P for trendwhereas a risk scorehigh risk of early mortality after ICD implantation. This may be helpful in consideration of ICD risk/benefit for individual patients. Further studies conducted in a prospective manner using these clinical criteria are warranted.

关键词：心脏病患者埋藏式除颤器早期死亡率植入后评分风险预测 logistic回归法临床三级医疗中心

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

埋藏式心脏复律除颤器对晚期心衰患者生存情况和再次入院的影响

引用

世界核心医学期刊文摘（心脏病学分册） 2006年第5期2卷 21-21页

作者： Nazarian S Maisel W.H.Miles J.S. 宁宁 Division of Cardiology Johns Hopkins Hospital Carnegie 568 600 NWolfe St Baltimore MD 21287 United StatesDr.

Background: Although implantable cardioverter defibrillators(ICDs)are increasingly used in advanced(class III/IV)heart failure, their benefits may be limited by death from pump failure and data are limited. The aim of this study was to assess the impact of QRS duration and disease etiology on survival and rehospitalization in advanced heart failure patients with ICDs. Methods: A retrospective study of 438 patients with heart failure(age 56± 15, ejection fraction 29± 15, 76% class III/IV)discharged between 1996 and 2000 was performed. Results: An ICD was placed in 94 of the 438 patients for nonsustained(51.1% )or sustained(24.4% )ventricular arrhythmia, syncope(16.0% ), or prophylaxis(8.5% ). Patients with ICDs had a lower mean baseline ejection fraction(25% vs 30% , P=.007)but a trend toward fewer class IV symptoms(33% vs 44% , P=.164). Patients with ICDs had better survival(RR 0.48, P=.001)but increased rehospitalization(RR 1.41, P=.031). In both the ischemic and nonischemic subgroups, survival was superior in patients with ICDs(RR 0.38, P=.003 and RR 0.54, P=.042). Patients with QRShad a trend toward better survival with an ICD(RR 0.42, P=.119)but increased rehospitalization(RR 2.13, P=.021). Patients with QRS ≥ 120 milliseconds had better survival with an ICD(RR 0.45, P=.001)without increased risk of rehospitalization(RR 1.22, P=.314). Conclusions: Patients with advanced heart failure selected to receive ICDs have better survival trends but shorter time to rehospitalization than patients without ICDs. Benefit appears greater for those with prolonged QRS duration.

关键词：埋藏式心脏复律除颤器心衰患者再次入院生存情况晚期室性心律失常非持续性 QRS波群心功能分级 ICD

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

心衰患者发生房颤时即使心室功能保留但死亡风险仍高

引用

世界核心医学期刊文摘(心脏病学分册) 2006年第2期 29-29页

作者： Parkash R. maisel w. h. Toca F. M. Stevenson w. G. 任付先 Queen Elizabeth II health Sciences Centre 1796 Summer Street halifax NS B3h 3A7 Canada Dr.

Background: The purpose of this study was to determine if patients with atrial fibrillation(AF) and heart failure(hF) have a better prognosis when systolic function is preserved as compared with those with depressed systolic function. Methods: Data from consecutive patients presenting to the emergency department at Brigham and women’ s hospital from January 1997 to December 2002 who had a diagnosis of AF and hF and a measure of ejection fraction(EF) were reviewed. Vital status was determined from the Social Security Death Index. Results: Of 478 patients(mean age 74± 13 years; 47% women), EF was preserved(>50% ) in 46% . Those with preserved left ventricular(LV) function were older(76 vs 72 years, Pwomen(62 vs 35% , Phave a history of hypertension and pulmonary disease and less likely to have had a prior myocardial infarction. At 5 years, mortality was similar between the preserved and depressed EF groups(50% vs 48% , P=.74). In multivariable analysis, age >75 years, history of cancer, cerebrovascular disease, aortic valve disease, serum creatinine >2.0 mg/dL, and serum sodiumwere associated with increased mortality. Therapy with β -blockers and angiotensin-converting enzyme inhibitors/angiotensin receptor blocker were associated with lower mortality. Conclusion: Patients who present to the emergency department with AF, hF, and preserved LVEF have a similarly high mortality as compared with those with depressed LVEF. Further study is needed to assess the impact of therapies and clarify the reasons for the poor prognosis.

关键词：房颤患者心房纤颤 LVEF 收缩功能

来源：

同方期刊数据库评论

在线全文

同方期刊数据库

学校读者我要写书评

暂无评论

欢迎您,

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

请选择保存的检索档案：

请选择收藏分类：

通借通还

欢迎您,

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：