冠動脈疾患の女性における心不全の予測要因
Kirsten Bibbins-Domingo1, Feng Lin, Eric Vittinghoff
1Division of General Internal Medicine, San Francisco General Hospital, University of California, San Francisco, San Francisco, CA 94143-1364, USA. bibbinsk@medicine.ucsf.edu
Circulation
|September 9, 2004
まとめ
糖尿病は,冠動脈疾患を有する閉経後の女性の心不全の最も強い予測因子であり,特に制御が不十分な場合です. 他の重要な危険因子には,心房細動,喫煙,肥満が含まれます.
科学分野:
- 心臓病学 心臓病学
- エンドクリノロジー エンドクリノロジー
- ゲリアトリクス ゲリアトリクス
背景:
- 心不全は,冠動脈疾患を持つ閉経後の女性の重要な懸念事項です.
- この集団における心不全のリスク要因は十分に確立されていません.
研究 の 目的:
- 既定の冠動脈疾患を有する閉経後の女性において心不全を発症させる危険因子を特定する.
主な方法:
- 心臓とエストロゲン/プロゲステン置換研究 (HERS) とHERS II.からのデータを用いた前向きなコホート研究.
- 2391人の冠動脈疾患の閉経後の女性を6.3年間追跡し,発症初期に心不全はなかった.
- インシデント心不全は,心不全による入院または死亡によって定義される.
主要な成果:
- 237人の女性 (10%) が心不全を発症しました.
- 9つの予測要因が特定されました:糖尿病,心房細動,心筋梗塞,低クレアチニンクリアランス,高静脈血圧,現在の喫煙,高体量指数,左束枝ブロック,左心室高縮.
- 糖尿病は最も強いリスク因子でした (調整された危険比率=3.1).
結論:
- 冠動脈疾患の閉経後の女性の心不全の9つの主要な予測要因を特定しました.
- 糖尿病は主な危険因子であり,特に低血糖コントロール,肥満,腎不全の場合は特に危険因子です.
- エストロゲン/プロゲステン療法は,心不全のリスクと関連しませんでした.
さらに関連する動画
04:05Clinical Application of Phase Angle and BIVA Z-Score Analyses in Patients Admitted to an Emergency Department with Acute Heart Failure
Published on: June 30, 2023
05:16Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure
Published on: June 10, 2025
関連する概念動画
01:17Pathophysiology of Heart Failure
Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
01:30Coronary Artery Disease I: Introduction
Coronary Artery Disease (CAD): An Overview with Scientific InsightsCoronary Artery Disease (CAD), often referred to as C-A-D, is a prevalent blood vessel disorder classified under the broader category of atherosclerosis. Atherosclerosis is a pathological process characterized by the hardening and narrowing of arteries due to the accumulation of atherosclerotic plaques. These plaques are composed of cholesterol, fatty substances, inflammatory cells, calcium, and fibrin, reducing blood flow to...
01:27Heart Failure I: Introduction
Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...
01:29Heart Failure II: Pathophysiology
Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
01:30Heart Failure IV: Classification and Diagnostic Evaluation
Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...
01:30Heart Failure VII: Nursing Interventions
The first step in nursing management of a patient with heart failure involves thoroughly assessing the patient's medical history.Subjective Data: Obtain the patient's medical history of coronary artery disease, hypertension, myocardial infarction, and symptoms like dyspnea, orthopnea, and paroxysmal nocturnal dyspnea.Objective Data: Conduct a physical examination to identify findings such as jugular vein distention, pulmonary crackles, tachycardia, murmurs, peripheral edema, and vital signs,...