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작성일 : 14-11-06 09:25
연구단계 1단계 :1년차
논문제목(영문) QRS morphology and ventricular dyssynchrony in patients with chronic right ventricular pacing.
국내외구분 국외 SCI여부 SCI
연구책임자역활 공저자 논문기여율 30%
주저자명 Lee KH
교신저자명 Cho JG
공동저자명 Park HW, Yoon NS, Kim SS, Kim MR, Kim MC, Cho KH, Kim HK, Kim CH, Kim KH, Jun SJ, Kim WJ, Lee KJ, Jeong HC, Cho JY, Park KH, Sim DS, Yoon HJ, Kim KH, Hong YJ, Kim JH, Ahn Y, Jeong MH, Park JC
게제년월일 2014-10-20
ISSN 0167-5273
Impact Factor 6.175
학술지명 Int J Cardiol
서지사항 0집 / 176권 / 3호,   페이지(962 - 968)
병기표기 1개
Acknowledgement
기재여부

※ Acknowledgement가 기재된 논문만 연구과제의 성과로 인정.
- 국문 표기 : "본 연구는 보건복지부 보건의료연구개발사업의 지원에 의하여 이루어진 것임. (HI13C1527)"
- 영문 표기 : "This study was supported by a grant of the Korean Health Technology R&D Project,
(HI13C1527) Ministry of Health & Welfare, Republic of Korea. "
요약초록문
(Abstract) 입력
BACKGROUND: Mechanical dyssynchrony (MD) is associated with poor outcomes in many different populations. However, the predictors for the development of MD after chronic right ventricular (RV) pacing are not well known.
METHODS: Pacing QRS morphology and MD using echocardiography was analyzed in 175 consecutive patients that have pacemaker implantation during a 7.6year median follow-up. Predictive score for MD was constructed using QRS morphology variables and calculated by summing the points of the 4 variables: duration (≥150ms, 1 point), transition (1 point), notching (2 points), and left-axis deviation (1 point), based on a multivariate-adjusted risk relationship with MD.
RESULTS: Sixty-eight (38.9%) patients developed MD. Patients with MD had worsened left ventricular systolic function (ejection fraction from 64.6±10.6% to 59.1±10.4%, p<0.001) and heart failure symptoms (New York Heart Association functional class increase from 1.1±0.3 to 1.9±0.8, p<0.001). In an electrocardiographic analysis, QRS duration ≥150ms, the presence of precordial axis transition, notching, and left-axis deviation were strongly associated with MD. Predictive score for MD using QRS morphology parameters displayed an excellent graded relationship with MD (score 0: 3.4% vs. 1: 12.5% vs. 2: 22.6% vs. 3: 45.0% vs. 4: 57.9% vs. 5: 72.7%, linear p<0.001) (model performance c-static 0.78, 95% confidence interval 0.72-0.85, p<0.001).
CONCLUSION: Patients with MD experienced a decline in left ventricular systolic function and an increase in heart failure symptoms after chronic RV pacing. A new scoring system using QRS morphology is considered a simple and efficient tool for predicting the development of MD after chronic RV pacing.

 
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