摘要
目的分析左心室收缩功能不全(LVSD)患者继发左束支传导阻滞(LBBB)的相关危险因素,建立相应列线图模型并评价其有效性。方法连续入选2018年7月至2019年7月于华中阜外医院住院诊治且左心室射血分数(LVEF)<50%患者940例,根据7∶3分为训练集(658例)和验证集(282例),采用单因素及多因素logistic回归分析方法筛选相关危险因素并构建列线图模型。结果多因素logistic回归分析发现,年龄、冠心病、扩张型心肌病(DCM)以及左心室舒张末期内径(LVEDD)是LVSD继发LBBB的独立危险因素(P<0.05)。利用上述指标建立了LVSD继发LBBB的列线图模型,ROC结果显示,训练集AUC为0.869(95%CI 0.822~0.916);验证集AUC为0.781(95%CI 0.682~0.881),且采用Bootstrap重复1000次抽样的方法对列线图模型进行内部验证后,预测模型校准曲线质量较高。结论年龄、冠心病、DCM以及LVEDD是LVSD继发LBBB的独立危险因素。本研究建立的列线图模型有良好的预测效能和区分度,可预测LVSD患者继发LBBB的风险。
Objective To explore the risk factors of left bundle branch block(LBBB)secondary to left ventricular systolic dysfunction(LVSD)patients,establish and evaluate the nomogram model.Methods A total of 940 hospitalized patients with left ventricular ejection fraction(LVEF)<50%who were treated at The Central China Fuwai Hospital from July 2018 to July 2019 were included.The patients were divided into a training set(658 cases)and a testing set(282 cases)at a ratio of 7:3.Univariate and multiple logistic regression analysis methods were used to analyze relevant risk factors and construct the nomogram model.Results Multiple logistic regression analysis revealed that age,coronary artery disease,dilated cardiomyopathy(DCM)and left ventricular end diastolic diameter(LVEDD)were the independent risk factors of LBBB secondary to LVSD(P<0.05).The nomogram model for predicting LBBB secondary to LVSD was established using the above factors.The ROC results showed an AUC of 0.869(95%CI 0.822-0.916)for the training set and an AUC of 0.781(95%CI 0.682-0.881)for the testing set.Additionally,after the internal validation of the nomogram model using Bootstrap resampling 1000 times,the predictive model calibration curve quality was higher.Conclusion Age,coronary artery disease,DCM and LVEDD were the independent risk factors of LBBB secondary to LVSD.The nomogram model established in this study had good predictive efficacy and discriminative ability,making it capable of predicting the risks of LBBB secondary to LVSD patients.
作者
李慕嶂
陈佳莹
陈书芳
吴金涛
张雷明
李雪洁
孟令娟
LI Mu-zhang;CHEN Jia-ying;CHEN Shu-fang;WU Jin-tao;ZHANG Lei-ming;LI Xue-jie;MENG Ling-juan(Department of Cardiology,Central China Fuwai Hospital of Zhengzhou University,Zhengzhou 450000,China;Arrhyth Center,Fuwai Central China Cardiovascular Hospital(Heart Central of Henan Provincial People’s Hospital),Zhengzhou 450000,China)
出处
《中国心血管病研究》
CAS
2024年第11期1028-1033,共6页
Chinese Journal of Cardiovascular Research
基金
河南省医学科技攻关计划省部共建项目(SBGJ202002030)。
关键词
左心室收缩功能不全
左束支传导阻滞
列线图
Left ventricular systolic dysfunction
Left bundle branch block
Nomogram
