Annals of Noninvasive Electrocardiology最新文献_第9页

Distribution Patterns of Paroxysmal Atrial Fibrillation Triggers and Catheter Ablation Success Rates 阵发性心房颤动触发因素的分布规律与导管消融成功率

IF 1.1 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Annals of Noninvasive Electrocardiology

Pub Date : 2025-03-24 DOI: 10.1111/anec.70065

Dongsheng Zhao, Yan Dong, Qiushi Chen, Fengxiang Zhang, Koulong Zheng

Objective

Investigate the distribution of triggers in paroxysmal atrial fibrillation (PAF) patients and assess the efficacy of circumferential pulmonary vein isolationI (CPVI) combined with non-pulmonary veins (PV) trigger ablation over 1 year.

Methods

This prospective study included 130 PAF patients undergoing initial catheter ablation. A standardized protocol was applied before CPVI, followed by ablation targeting non-PV triggers. Ablation success was marked by the inability to induce atrial fibrillation (AF) or related arrhythmias. Patients underwent Holter monitoring at intervals post-surgery, culminating in a 7-day exam at 12 months.

Results

Atrial fibrillation (AF) was induced in 88 patients (67.0%), with 94 foci identified. The left pulmonary vein was a common source, but the superior vena cava emerged as the most prevalent non-PV site. The 1-year success rate was 86.0%, with no significant differences in success rates among trigger types. However, non-PV triggers were linked to lower recurrence rates post-surgery (HR 0.27, 95% CI 0.08–0.96, p = 0.04).

Conclusion

The study found that the combination of drug stimulation and high-frequency atrial stimulation before CPVI significantly boosted AF induction rates and revealed a high incidence of non-PV triggers. Effective intraoperative induction and accurate identification of non-PV triggers, particularly in the superior vein cava (SVC), contributed to a substantial reduction in postoperative recurrence rates. This approach suggests a potential strategy for improving outcomes in PAF treatment.

目的探讨阵发性心房颤动（PAF）患者触发因素的分布，评价环肺静脉隔离（CPVI）联合非肺静脉（PV）触发消融治疗1年以上的疗效。方法本前瞻性研究纳入130例首次行导管消融的PAF患者。CPVI前采用标准化方案，随后针对非pv触发因素进行消融。消融成功的标志是不能诱发心房颤动（AF）或相关心律失常。患者术后每隔一段时间进行动态心电图监测，12个月时进行为期7天的检查。结果诱发心房颤动88例（67.0%），确定94个灶。左肺静脉是常见的来源，但上腔静脉是最常见的非pv部位。1年成功率为86.0%，不同触发类型的成功率无显著差异。然而，非pv诱因与术后复发率较低相关（HR 0.27, 95% CI 0.08-0.96, p = 0.04）。结论本研究发现，CPVI前联合药物刺激和高频心房刺激可显著提高AF诱导率，非pv诱因发生率较高。术中有效的诱导和准确识别非pv诱因，特别是在上腔静脉（SVC），有助于大幅降低术后复发率。这种方法为改善PAF治疗结果提供了一种潜在的策略。

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引用次数: 0

Association of Frailty With Clinical Outcomes in Patients Receiving Primary Prevention Implantable Cardioverter Defibrillators: A Prospective Cohort Study 接受一级预防植入式心律转复除颤器患者虚弱与临床结果的关联：一项前瞻性队列研究

IF 1.1 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Annals of Noninvasive Electrocardiology

Pub Date : 2025-03-14 DOI: 10.1111/anec.70061

Dmitry Neymark, Christopher Lee, William F. McIntyre, Maria Higgins, James W. Tam, Colette Seifer

Background

Frailty predisposes individuals to morbidity and mortality. Increasing numbers of elderly and comorbid individuals are undergoing primary prevention implantable cardioverter defibrillator (ICD) device placement. Little is known about the association of frailty with post-device implantation outcomes.

Methods

We conducted a single-center, prospective cohort study of 71 patients who underwent primary prevention ICD insertion and who had their baseline frailty status assessed using the Fried index. Participants were followed for a median period of 7.8 years.

Results

The mean age (± SD) was 70.6 ± 4.5 years. 12 (17%) patients met the criteria for frailty. 23 (33%) patients received cardiac resynchronization therapy. Frailty was associated with a significantly higher incidence of mortality (HR [95% CI]; 3.9 [1.2–12.1]), ED visits (2.7 [1.1–6.7]), and hospitalizations (2.8 [1.1–7.6]). Within the non-frail cohort, there was no association between Fried frailty scores and adverse outcomes. None of the frail patients received appropriate shock therapy.

Conclusion

Among primary prevention ICD recipients, frailty is associated with worse mortality and morbidity. Clinicians should consider frailty when discussing risks and benefits with this patient population.

背景虚弱容易导致发病和死亡。越来越多的老年人和合并症患者正在接受一级预防植入式心律转复除颤器（ICD）装置植入手术。人们对虚弱与设备植入后结果的关系知之甚少。方法我们对 71 名接受一级预防 ICD 植入术的患者进行了单中心前瞻性队列研究，并使用弗里德指数评估了他们的基线虚弱状态。参与者的随访时间中位数为 7.8 年。结果平均年龄（± SD）为 70.6±4.5 岁。12（17%）名患者符合虚弱标准。23（33%）名患者接受了心脏再同步化治疗。体弱与死亡率（HR [95% CI]；3.9 [1.2-12.1]）、急诊室就诊率（2.7 [1.1-6.7]）和住院率（2.8 [1.1-7.6]）明显较高有关。在非虚弱人群中，弗里德虚弱评分与不良后果之间没有关联。所有体弱患者均未接受适当的电击治疗。结论在一级预防 ICD 患者中，体弱与死亡率和发病率的恶化有关。临床医生在与这一患者群体讨论风险和获益时应考虑体弱因素。

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引用次数: 0

Bidirectional Ventricular Tachycardia due to Pheochromocytoma: A Case Report 嗜铬细胞瘤所致双向室性心动过速1例

IF 1.1 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Annals of Noninvasive Electrocardiology

Pub Date : 2025-03-12 DOI: 10.1111/anec.70063

Gui-yang Li, Man-Xin Lin, Fa-Guang Zhou, Qiang Li

Pheochromocytoma, a type of neuroendocrine tumor, can cause numerous symptoms and signs similar to those of other clinical conditions, with the classic triad being palpitations, headache, and diaphoresis. Patients with pheochromocytoma can present with various cardiac complications, including myocarditis, acute coronary syndromes, cardiomyopathy, heart failure, and arrhythmias. Here we report a case of pheochromocytoma that first presented with bidirectional ventricular tachycardia. The patient was initially diagnosed with acute viral myocarditis and was treated accordingly. A pheochromocytoma crisis with severe blood pressure fluctuation occurred after glucocorticoid administration, leading to further diagnostic work-up, which eventually revealed the adrenal pheochromocytoma.

嗜铬细胞瘤是一种神经内分泌肿瘤，可引起与其他临床疾病相似的许多症状和体征，典型的三联征是心悸、头痛和出汗。嗜铬细胞瘤患者可出现各种心脏并发症，包括心肌炎、急性冠状动脉综合征、心肌病、心力衰竭和心律失常。这里我们报告一个嗜铬细胞瘤的病例，首先表现为双向室性心动过速。患者最初被诊断为急性病毒性心肌炎并接受相应治疗。糖皮质激素治疗后出现严重血压波动的嗜铬细胞瘤危象，导致进一步的诊断检查，最终发现肾上腺嗜铬细胞瘤。

引用次数: 0

Causal Relationship Between Electrocardiogram Parameters and Brugada Syndrome: A Bidirectional Mendelian Randomization Study 心电图参数与Brugada综合征的因果关系：一项双向孟德尔随机研究

IF 1.1 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Annals of Noninvasive Electrocardiology

Pub Date : 2025-03-12 DOI: 10.1111/anec.70060

Songcui Shen, Xiaolu Wang, Jingjuan Huang, Wenzhao Li

Background

Brugada syndrome (BrS) is associated with an electrocardiogram (ECG), but the causal relationship remains unclear. This study aimed to assess the bidirectional causal relationship between ECG parameters and BrS using Mendelian randomization (MR) analysis.

Methods

A bidirectional MR analysis using data from the OpenGWAS database. Six ECG parameters, including PR interval, PP interval, ST duration, QRS duration, T wave duration, and QT interval, were included in the forward MR analysis with BrS as the outcome. In the reverse MR analysis, BrS was the exposure and the aforementioned ECG parameters were the outcomes. The inverse-variance weighted (IVW) method was the primary analytical approach, complemented by four other methods to account for potential pleiotropy. Sensitivity analyses were performed using Cochran's Q test, MR-Egger intercept, and leave-one-out analysis to evaluate heterogeneity and pleiotropy.

Results

In the forward MR, genetically predicted ST duration (OR = 1.3478, 95% CI: 1.0611–1.7118, p = 0.014) and QRS duration (OR = 0.9582, 95% CI: 0.9208–0.9972, p = 0.036) showed significant associations with BrS. The reverse MR indicated that BrS was significantly associated with PR interval, QRS duration, P wave duration, and QT interval (all p < 0.05). Sensitivity analyses confirmed the robustness of the results in both forward and reverse MR analyses. However, there were significant horizontal pleiotropy and heterogeneity in reverse MR analysis.

Conclusions

This MR study supported a causal effect of ECG parameters, including ST duration and QRS duration, on BrS development.

背景 Brugada 综合征（BrS）与心电图（ECG）有关，但其因果关系仍不清楚。本研究旨在利用孟德尔随机化（MR）分析法评估心电图参数与 Brugada 综合征之间的双向因果关系。方法利用 OpenGWAS 数据库的数据进行双向 MR 分析。包括 PR 间期、PP 间期、ST 间期、QRS 间期、T 波间期和 QT 间期在内的六个心电图参数被纳入正向 MR 分析，并以 BrS 为结果。在反向 MR 分析中，BrS 为暴露，上述心电图参数为结果。反方差加权（IVW）法是主要的分析方法，并辅以其他四种方法以考虑潜在的多效应。使用 Cochran's Q 检验、MR-Egger 截距和leave-one-out 分析进行了敏感性分析，以评估异质性和多向性。结果在正向 MR 中，遗传预测的 ST 持续时间（OR = 1.3478，95% CI：1.0611-1.7118，p = 0.014）和 QRS 持续时间（OR = 0.9582，95% CI：0.9208-0.9972，p = 0.036）与 BrS 有显著关联。反向 MR 显示，BRS 与 PR 间期、QRS 持续时间、P 波持续时间和 QT 间期显著相关（所有 p 均为 0.05）。敏感性分析证实了正向和反向 MR 分析结果的稳健性。然而，在反向 MR 分析中存在明显的水平多向性和异质性。结论这项磁共振研究支持心电图参数（包括 ST 持续时间和 QRS 持续时间）对 BrS 发展的因果效应。

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引用次数: 0

Frontal Plane QRS – T Angle Is a Predictor of Ventricular Arrhythmia in Heart Failure With Preserved Ejection Fraction 额平面QRS - T角是保留射血分数的心力衰竭患者室性心律失常的预测因子

IF 1.1 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Annals of Noninvasive Electrocardiology

Pub Date : 2025-03-12 DOI: 10.1111/anec.70062

Çağrı Zorlu, Barış Açıkel, Sefa Erdi Ömür

Introduction

Various ventricular repolarization parameters are known to predict ventricular arrhythmias and mortality in various diseases. Although mortality in patients with heart failure with preserved ejection fraction (HFpEF) is similar to that in heart failure with reduced ejection fraction patients, studies on this subject are more limited. Therefore, it is important to evaluate the relationship between ventricular arrhythmias and mortality and ventricular repolarization parameters, especially the frontal plane QRS–T angle, in patients with HFpEF.

Methods

Electrocardiographic, echocardiographic, and laboratory data of 811 patients were evaluated, and the fQRST angle was calculated on ECG. The occurrence of ventricular tachycardia, ventricular fibrillation, or sudden death within a mean of 48 ± 12 months was recorded. Statistical significance was determined as p < 0.05.

Results

A total of 811 patients were evaluated, 180 patients in the cardiac event group and 631 patients in the no cardiac event group. NT-proBNP, La size, La volume index, Tp-e time, Tp-e/QTc ratio, and fQRS-T angle were statistically significantly higher in the cardiac event group. NT-proBNP level and fQRS-T angle were found to be independent predictors of mortality in multivariate cox analysis. According to ROC analysis, when QRS-T angle has a cut-off value of 58.63, its sensitivity is 81.2, and its specificity is 79.3. Kaplan-Meier analysis also found that when the fQRS-T angle was > 58.63, mortality was higher than at narrower angles.

Conclusions

According to our study, the fQRS-T angle, which can be easily and inexpensively calculated on ECG, predicts long-term ventricular arrhythmias in patients with HFpEF.

各种心室复极参数可以预测各种疾病的室性心律失常和死亡率。尽管保留射血分数（HFpEF）心力衰竭患者的死亡率与降低射血分数心力衰竭患者相似，但这方面的研究更为有限。因此，评价HFpEF患者室性心律失常与死亡率与心室复极参数，尤其是额平面QRS-T角的关系具有重要意义。方法对811例患者的心电图、超声心动图及实验室资料进行分析，计算心电图fQRST角。记录在平均48±12个月内发生室性心动过速、室性颤动或猝死的情况。p <； 0.05为有统计学意义。结果共评估811例患者，其中心脏事件组180例，无心脏事件组631例。心脏事件组NT-proBNP、La大小、La容积指数、Tp-e时间、Tp-e/QTc比值、fQRS-T角均显著增高。多因素cox分析发现NT-proBNP水平和fQRS-T角度是死亡率的独立预测因子。根据ROC分析，当QRS-T角度截断值为58.63时，其敏感性为81.2，特异性为79.3。Kaplan-Meier分析还发现，当fQRS-T角度为58.63时，死亡率高于较窄角度。结论fQRS-T角可预测HFpEF患者的长期室性心律失常，在心电图上计算简便、成本低。

{"title":"Frontal Plane QRS – T Angle Is a Predictor of Ventricular Arrhythmia in Heart Failure With Preserved Ejection Fraction","authors":"Çağrı Zorlu, Barış Açıkel, Sefa Erdi Ömür","doi":"10.1111/anec.70062","DOIUrl":"https://doi.org/10.1111/anec.70062","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Various ventricular repolarization parameters are known to predict ventricular arrhythmias and mortality in various diseases. Although mortality in patients with heart failure with preserved ejection fraction (HFpEF) is similar to that in heart failure with reduced ejection fraction patients, studies on this subject are more limited. Therefore, it is important to evaluate the relationship between ventricular arrhythmias and mortality and ventricular repolarization parameters, especially the frontal plane QRS–T angle, in patients with HFpEF.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Electrocardiographic, echocardiographic, and laboratory data of 811 patients were evaluated, and the fQRST angle was calculated on ECG. The occurrence of ventricular tachycardia, ventricular fibrillation, or sudden death within a mean of 48 ± 12 months was recorded. Statistical significance was determined as <i>p</i> < 0.05.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 811 patients were evaluated, 180 patients in the cardiac event group and 631 patients in the no cardiac event group. NT-proBNP, La size, La volume index, Tp-e time, Tp-e/QTc ratio, and fQRS-T angle were statistically significantly higher in the cardiac event group. NT-proBNP level and fQRS-T angle were found to be independent predictors of mortality in multivariate cox analysis. According to ROC analysis, when QRS-T angle has a cut-off value of 58.63, its sensitivity is 81.2, and its specificity is 79.3. Kaplan-Meier analysis also found that when the fQRS-T angle was > 58.63, mortality was higher than at narrower angles.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>According to our study, the fQRS-T angle, which can be easily and inexpensively calculated on ECG, predicts long-term ventricular arrhythmias in patients with HFpEF.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"30 2","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70062","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143595572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Predictive Value of Noninvasive Cardiac Function Monitoring Combined With GRACE Score for Short-Term Outcomes in Patients With ST-Segment Elevation Myocardial Infarction 无创心功能监测联合GRACE评分对st段抬高型心肌梗死患者短期预后的预测价值

IF 1.1 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Annals of Noninvasive Electrocardiology

Pub Date : 2025-02-26 DOI: 10.1111/anec.70056

Jiayan Xin, Yingwu Liu, Meng Ning, Chong Zhang

Objective

To investigate the correlation between non-invasive cardiac function monitoring indexes and recent adverse prognosis in patients with STEMI. The hemodynamic indexes with high diagnostic value were selected to construct a new risk prediction model combined with GRACE scores, and the efficiency of the new prediction model was evaluated.

Methods

STEMI patients who met the inclusion and exclusion criteria were selected. All patients were followed for 6 months of major adverse cardiovascular events (MACE). The non-invasive cardiac function monitoring indexes were analyzed by univariate and multivariate logistic regression. The ROC curve was used to evaluate the accuracy of non-invasive cardiac function indexes predicting MACE. Then, a new risk prediction model was established and its prediction efficiency was evaluated by ROC curve.

Results

Patients were divided into MACE group (N = 69) and non-MACE group (N = 173), stroke volume (SV), cardiac output (CO), cardiac index (CI), cardiac time intervals (CTI), early diastolic filling rate (EDFR), end-diastolic volume (EDV), and systemic vascular resistance (SVR) were found to be significant predictors of recent MACE events in STEMI patients. Multivariate logistic regression analysis confirmed that indicators of noninvasive cardiac function were independent predictors. In addition, the combination of SV and CTI with the GRACE score has the potential to enhance the predictive accuracy for MACE.

Conclusion

Non-invasive hemodynamic indicators SV, CO, CI, CTI, EDFR, EDV and SVR can not only independently predict the risk of recent MACE in patients with STEMI, but can also be used as joint indicators to significantly improve the predictive ability of GRACE score.

目的探讨STEMI患者无创心功能监测指标与近期不良预后的相关性。选择具有较高诊断价值的血流动力学指标，结合GRACE评分构建新的风险预测模型，并对新预测模型的有效性进行评价。方法选择符合纳入标准和排除标准的STEMI患者。所有患者随访6个月的主要不良心血管事件（MACE）。采用单因素和多因素logistic回归分析无创心功能监测指标。采用ROC曲线评价无创心功能指标预测MACE的准确性。然后，建立了新的风险预测模型，并用ROC曲线评价其预测效率。结果将患者分为MACE组（N = 69）和非MACE组（N = 173），发现卒中容量（SV）、心输出量（CO）、心脏指数（CI）、心脏时间间隔（CTI）、早期舒张充盈率（EDFR）、舒张末期容积（EDV）和全身血管阻力（SVR）是STEMI患者近期MACE事件的重要预测因子。多因素logistic回归分析证实无创心功能指标为独立预测因子。此外，SV和CTI与GRACE评分的结合有可能提高MACE的预测精度。结论无创血流动力学指标SV、CO、CI、CTI、EDFR、EDV、SVR不仅可以独立预测STEMI患者近期MACE的发生风险，而且可以作为GRACE评分的联合指标，显著提高GRACE评分的预测能力。

{"title":"Predictive Value of Noninvasive Cardiac Function Monitoring Combined With GRACE Score for Short-Term Outcomes in Patients With ST-Segment Elevation Myocardial Infarction","authors":"Jiayan Xin, Yingwu Liu, Meng Ning, Chong Zhang","doi":"10.1111/anec.70056","DOIUrl":"https://doi.org/10.1111/anec.70056","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate the correlation between non-invasive cardiac function monitoring indexes and recent adverse prognosis in patients with STEMI. The hemodynamic indexes with high diagnostic value were selected to construct a new risk prediction model combined with GRACE scores, and the efficiency of the new prediction model was evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>STEMI patients who met the inclusion and exclusion criteria were selected. All patients were followed for 6 months of major adverse cardiovascular events (MACE). The non-invasive cardiac function monitoring indexes were analyzed by univariate and multivariate logistic regression. The ROC curve was used to evaluate the accuracy of non-invasive cardiac function indexes predicting MACE. Then, a new risk prediction model was established and its prediction efficiency was evaluated by ROC curve.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients were divided into MACE group (<i>N</i> = 69) and non-MACE group (<i>N</i> = 173), stroke volume (SV), cardiac output (CO), cardiac index (CI), cardiac time intervals (CTI), early diastolic filling rate (EDFR), end-diastolic volume (EDV), and systemic vascular resistance (SVR) were found to be significant predictors of recent MACE events in STEMI patients. Multivariate logistic regression analysis confirmed that indicators of noninvasive cardiac function were independent predictors. In addition, the combination of SV and CTI with the GRACE score has the potential to enhance the predictive accuracy for MACE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Non-invasive hemodynamic indicators SV, CO, CI, CTI, EDFR, EDV and SVR can not only independently predict the risk of recent MACE in patients with STEMI, but can also be used as joint indicators to significantly improve the predictive ability of GRACE score.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"30 2","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70056","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143489981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Predictive Value of Blood and Echocardiographic Indicators for Nonvalvular Atrial Fibrillation in Postmenopausal Women 血液和超声心动图指标对绝经后妇女非瓣膜性心房颤动的预测价值

IF 1.1 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Annals of Noninvasive Electrocardiology

Pub Date : 2025-02-25 DOI: 10.1111/anec.70053

Lei Song, Xiao-Ping Shen, Jian-Rong Cai, Hong-Lei Zhang, Gui-Ru Li, Jing Shi

Objective

To evaluate the association and predictive value of midregional pro-atrial natriuretic peptide (MR-proANP), bone morphogenetic protein (BMP-7), and left atrial diameter (LAD) with nonvalvular atrial fibrillation (NVAF) in postmenopausal women.

Methods

This retrospective study included 288 postmenopausal women treated at Chongming Hospital Affiliated to Shanghai University of Medicine and Health Sciences from January 2022 to October 2024. Patients were categorized into the NVAF and control groups based on electrocardiogram findings. Observation indicators were LAD, MR-proANP, BMP-7, homocysteine (Hcy), and free thyroxine (FT4). Echocardiography excluded valvular disease and measured LAD. Serum biomarkers were quantified using ELISA. Logistic regression identified independent risk factors, and ROC curves assessed predictive value.

Results

Of the 288 participants, 175 (61%) had NVAF. MR-proANP (425.8 vs. 289.4 nmol/L, p < 0.001), and LAD (38.4 vs. 32.5 mm, p < 0.001) were significantly higher in the NVAF group, whereas BMP-7 levels were lower (2.22 vs. 2.67 pg/L, p < 0.001). Additionally, Hcy (13.59 vs. 11.64 nmol/L, p = 0.023) and FT4 (16.91 vs. 15.85 nmol/L, p = 0.014) levels were also significantly elevated in the NVAF group. Multivariate logistic regression showed MR-proANP (OR 1.005, 95% CI 1.001–1.008), BMP-7 (OR 0.338, 95% CI 0.226–0.504), and LAD (OR 1.291, 95% CI 1.205–1.383) as independent risk factors for NVAF. Combined ROC analysis for MR-proANP, BMP-7, and LAD demonstrated an area under the curve (AUC) of 0.803, indicating superior predictive sensitivity and specificity than one indicator alone.

Conclusion

MR-proANP, BMP-7, and LAD are independent risk factors for NVAF in postmenopausal women. Their combined measurement provides valuable predictive insights, aiding in clinical decision-making.

目的探讨中区域前房利钠肽（MR-proANP）、骨形态发生蛋白（BMP-7）、左房内径（LAD）与绝经后妇女非瓣膜性房颤（NVAF）的相关性及预测价值。方法对2022年1月至2024年10月在上海医科大学附属崇明医院接受治疗的绝经后妇女288例进行回顾性研究。根据心电图结果将患者分为非瓣膜性房颤组和对照组。观察指标为LAD、MR-proANP、BMP-7、同型半胱氨酸（Hcy）、游离甲状腺素（FT4）。超声心动图排除瓣膜疾病并测量LAD。采用ELISA对血清生物标志物进行定量分析。Logistic回归识别独立危险因素，ROC曲线评估预测价值。结果288名参与者中，175名（61%）患有非瓣膜性房颤。NVAF组MR-proANP （425.8 vs. 289.4 nmol/L, p < 0.001）和LAD （38.4 vs. 32.5 mm, p < 0.001）水平显著升高，而BMP-7水平较低（2.22 vs. 2.67 pg/L, p < 0.001）。此外，NVAF组Hcy （13.59 vs. 11.64 nmol/L, p = 0.023）和FT4 （16.91 vs. 15.85 nmol/L, p = 0.014）水平也显著升高。多因素logistic回归显示MR-proANP （OR 1.005, 95% CI 1.001-1.008）、BMP-7 （OR 0.338, 95% CI 0.226-0.504）和LAD （OR 1.291, 95% CI 1.205-1.383）为非瓣瓣性房颤的独立危险因素。MR-proANP、BMP-7和LAD的联合ROC分析显示，曲线下面积（AUC）为0.803，表明预测敏感性和特异性优于单独使用一项指标。结论MR-proANP、BMP-7、LAD是绝经后妇女非瓣瓣性房颤的独立危险因素。他们的综合测量提供了有价值的预测见解，有助于临床决策。

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引用次数: 0

Syncope Linked to QT-Interval Prolongation and Global T-Wave Inversion: A Clinical Case of Acute Pulmonary Embolism 与 QT 间期延长和全局 T 波倒置相关的晕厥：急性肺栓塞的临床病例。

IF 1.1 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Annals of Noninvasive Electrocardiology

Pub Date : 2025-02-14 DOI: 10.1111/anec.70049

Xue-Yan Zhang, Jing-Xiu Li, Min Gao, Xue-Qi Li, Ming-Yu Zhang

The incidence and mortality rates of acute pulmonary embolism (APE) are high in clinical emergencies, making early diagnosis and risk stratification crucial. Electrocardiogram (ECG) plays a significant role in guiding the diagnosis and differential diagnosis of pulmonary embolism. Acute pulmonary embolism can present with various ECG manifestations. The presence of pulmonary hypertension and increased right ventricular load in pulmonary embolism can lead to T wave inversion in the right cardiac lead. Additionally, some patients may exhibit a prolonged QT interval, which is associated with the pathophysiological processes resulting from both pulmonary hypertension and myocardial ischemia.

急性肺栓塞（APE）的发病率和死亡率在临床急诊中很高，因此早期诊断和风险分层至关重要。心电图对肺栓塞的诊断和鉴别诊断具有重要的指导作用。急性肺栓塞可表现为多种心电图表现。肺动脉高压的存在和肺动脉栓塞时右心室负荷的增加可导致右心导联T波倒置。此外，一些患者可能表现出QT间期延长，这与肺动脉高压和心肌缺血引起的病理生理过程有关。

引用次数: 0

Left Bundle Branch Pacing in a Pediatric Patient With Tricuspid Valve Replacement for a Complex Ebstein Anomaly 小儿三尖瓣置换术治疗复杂Ebstein异常的左束支起搏

IF 1.1 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Annals of Noninvasive Electrocardiology

Pub Date : 2025-02-11 DOI: 10.1111/anec.70057

Di Tian, Longfu Jiang, Jiabo Shen

This paper presents a unique case of successful implementation of left bundle branch pacing (LBBP) in a pediatric patient with third-degree atrioventricular block following tricuspid valve replacement for a complex Ebstein anomaly. The procedure was performed under real-time recording technique, and resulted in the resolution of the patient's symptoms. This case underscores the feasibility and potential benefits of LBBP in pediatric patients, particularly in those with complex congenital heart conditions and following valve replacement surgery. The successful implementation of LBBP in this case provides valuable insights and a reference for similar cases in the future.

本文提出了一个独特的案例，成功实施左束支起搏（LBBP）的儿童患者三尖瓣置换术后，复杂的Ebstein异常的三度房室传导阻滞。该过程是在实时记录技术下进行的，并导致患者症状的缓解。本病例强调了LBBP在儿科患者中的可行性和潜在益处，特别是那些患有复杂先天性心脏病和瓣膜置换术后的患者。本案例中LBBP的成功实施为今后类似的案例提供了有价值的见解和参考。

引用次数: 0

Application of Veno-Arterial ECMO Combined With Hemoperfusion in the Treatment of a Patient With Yunaconitine Poisoning: A Case Report 静脉-动脉ECMO联合血液灌流治疗乌头碱中毒1例

IF 1.1 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Annals of Noninvasive Electrocardiology

Pub Date : 2025-02-07 DOI: 10.1111/anec.70051

Zhuo Jiang, Yue Zhuang, Xueting Hu, Wei Chen, Fei Xia, Xiaoxia Hu, Aixiang Yang, Weiyi Tao

A 40-year-old man, after accidentally ingesting aconitine in a herbal remedy, suffered severe poisoning symptoms and was diagnosed with multiple arrhythmias. He quickly received veno-arterial extracorporeal membrane oxygenation (VA-ECMO) and hemoperfusion in the ICU, along with continuous renal replacement therapy (CRRT) to stabilize his internal environment. The treatment controlled the arrhythmias, restored heart function, and alleviated acidosis. The patient was discharged feeling well after 9 days. This combined therapy is valuable for severe aconitine poisoning, especially when specific antidotes are lacking, as it provides critical life support and effectively removes toxins.

一名40岁的男子在不小心摄入了一种草药中的乌头碱后，出现了严重的中毒症状，并被诊断出患有多种心律失常。他迅速在ICU接受静脉-动脉体外膜氧合（VA-ECMO）和血液灌流，同时持续肾替代治疗（CRRT）以稳定其内环境。治疗后心律失常得到控制，心功能得到恢复，酸中毒得到缓解。9天后出院，感觉良好。这种联合疗法对严重的乌头碱中毒很有价值，特别是在缺乏特定解毒剂的情况下，因为它提供了关键的生命支持并有效地去除毒素。

引用次数: 0