Background Potentially lethal ventricular arrhythmias （PLVAs） occur frequently in survivors after acute myocardial infarction and are increasingly recognized in other forms of structural heart diseases.This study in...Background Potentially lethal ventricular arrhythmias （PLVAs） occur frequently in survivors after acute myocardial infarction and are increasingly recognized in other forms of structural heart diseases.This 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 tachycardia.All-cause mortality,sudden death,and rehospitalization due to worsening heart failure,or cardiac transplantation during 5-year follow-up after discharge were recorded.Results 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 PLVAs.Age （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 PLVAs.And 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 CHF.Conclusion PLVAs are common and exert a negative impact on Iona-term clinical outcome in patients with CHF.展开更多
An outbreak of coronavirus disease 2019(COVID-19) occurred in December 2019 due to severe acute respiratory syndrome coronavirus 2(SARS-Co V-2),which is a strain of SARS-Co V.Patients infected with the virus present a...An outbreak of coronavirus disease 2019(COVID-19) occurred in December 2019 due to severe acute respiratory syndrome coronavirus 2(SARS-Co V-2),which is a strain of SARS-Co V.Patients infected with the virus present a wide spectrum of manifestations ranging from mild flu-like symptoms,cough,fever and fatigue to severe lung injury,appearing as bilateral interstitial pneumonia or acute respiratory failure.Although SARS-Co V-2 infection predominantly offends the respiratory system,it has been associated with several cardiovascular complications as well.For example,patients with COVID-19 may either develop type 2 myocardial infarction due to myocardial oxygen demand and supply imbalance or acute coronary syndrome resulting from excessive inflammatory response to the primary infection.The incidence of COVID-19 related myocarditis is estimated to be accountable for an average of 7% of all COVID-19 related fatal cases,whereas heart failure(HF) may develop due to infiltration of the heart by inflammatory cells,destructive action of pro-inflammatory cytokines,micro-thrombosis and new onset or aggravated endothelial and respiratory failure.Lastly,SARSCo V-2 can engender arrhythmias through direct myocardial damage causing acute myocarditis or through HF decompensation or secondary,through respiratory failure or severe res-piratory distress syndrome.In this comprehensive review we summarize the COVID-19 related cardiovascular complications(acute coronary syndromes,myocarditis,HF,arrhythmias) and discuss the main underlying pathophysiological mechanisms.展开更多
目的分析希氏束起搏对慢性心力衰竭患者心功能、心律失常、运动能力及生活质量的影响。方法选取2021年1月—2023年1月黔东南苗族侗族自治州人民医院收治的60例慢性心力衰竭患者。所有患者均接受希氏束起搏植入术。对患者随访6个月,观察...目的分析希氏束起搏对慢性心力衰竭患者心功能、心律失常、运动能力及生活质量的影响。方法选取2021年1月—2023年1月黔东南苗族侗族自治州人民医院收治的60例慢性心力衰竭患者。所有患者均接受希氏束起搏植入术。对患者随访6个月,观察其治疗效果,对患者的心功能、心律失常、运动能力及生活质量等进行评价。结果(1)患者手术前后左室舒张末期容积(left ventricular end diastolic volume,LVEDV)、左室舒张末期内径(left ventricular end-diastolic diameter,LVEDd)指标比较,差异无统计学意义(P>0.05)。除左室射血分数(left ventricular ejection fractions,LVEF)、左室内压最大变化速率指标(maximum rate of change of left chamber pressure,LVdp/dt)高于术前外,术后其余心功能指标均比术前低,差异有统计学意义(P<0.05)。(2)手术前后的室性早搏比较,差异无统计学意义(P>0.05)。其余指标均术后优于术前,差异有统计学意义(P<0.05)。(3)术后各项生活质量分值均比术前高,差异有统计学意义(P<0.05)。结论希氏束起搏技术的应用能够有效改善慢性心力衰竭患者的预后,此种干预形式不仅促进患者心功能的提升,并且还可使心律失常状态得到缓解,有助于提高其运动能力、生活质量等。展开更多
文摘Background Potentially lethal ventricular arrhythmias （PLVAs） occur frequently in survivors after acute myocardial infarction and are increasingly recognized in other forms of structural heart diseases.This 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 tachycardia.All-cause mortality,sudden death,and rehospitalization due to worsening heart failure,or cardiac transplantation during 5-year follow-up after discharge were recorded.Results 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 PLVAs.Age （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 PLVAs.And 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 CHF.Conclusion PLVAs are common and exert a negative impact on Iona-term clinical outcome in patients with CHF.
文摘An outbreak of coronavirus disease 2019(COVID-19) occurred in December 2019 due to severe acute respiratory syndrome coronavirus 2(SARS-Co V-2),which is a strain of SARS-Co V.Patients infected with the virus present a wide spectrum of manifestations ranging from mild flu-like symptoms,cough,fever and fatigue to severe lung injury,appearing as bilateral interstitial pneumonia or acute respiratory failure.Although SARS-Co V-2 infection predominantly offends the respiratory system,it has been associated with several cardiovascular complications as well.For example,patients with COVID-19 may either develop type 2 myocardial infarction due to myocardial oxygen demand and supply imbalance or acute coronary syndrome resulting from excessive inflammatory response to the primary infection.The incidence of COVID-19 related myocarditis is estimated to be accountable for an average of 7% of all COVID-19 related fatal cases,whereas heart failure(HF) may develop due to infiltration of the heart by inflammatory cells,destructive action of pro-inflammatory cytokines,micro-thrombosis and new onset or aggravated endothelial and respiratory failure.Lastly,SARSCo V-2 can engender arrhythmias through direct myocardial damage causing acute myocarditis or through HF decompensation or secondary,through respiratory failure or severe res-piratory distress syndrome.In this comprehensive review we summarize the COVID-19 related cardiovascular complications(acute coronary syndromes,myocarditis,HF,arrhythmias) and discuss the main underlying pathophysiological mechanisms.
文摘目的分析希氏束起搏对慢性心力衰竭患者心功能、心律失常、运动能力及生活质量的影响。方法选取2021年1月—2023年1月黔东南苗族侗族自治州人民医院收治的60例慢性心力衰竭患者。所有患者均接受希氏束起搏植入术。对患者随访6个月,观察其治疗效果,对患者的心功能、心律失常、运动能力及生活质量等进行评价。结果(1)患者手术前后左室舒张末期容积(left ventricular end diastolic volume,LVEDV)、左室舒张末期内径(left ventricular end-diastolic diameter,LVEDd)指标比较,差异无统计学意义(P>0.05)。除左室射血分数(left ventricular ejection fractions,LVEF)、左室内压最大变化速率指标(maximum rate of change of left chamber pressure,LVdp/dt)高于术前外,术后其余心功能指标均比术前低,差异有统计学意义(P<0.05)。(2)手术前后的室性早搏比较,差异无统计学意义(P>0.05)。其余指标均术后优于术前,差异有统计学意义(P<0.05)。(3)术后各项生活质量分值均比术前高,差异有统计学意义(P<0.05)。结论希氏束起搏技术的应用能够有效改善慢性心力衰竭患者的预后,此种干预形式不仅促进患者心功能的提升,并且还可使心律失常状态得到缓解,有助于提高其运动能力、生活质量等。
