発射分子が保存された心不全における右心室機能:コミュニティベースの研究
Selma F Mohammed1, Imad Hussain2, Omar F AbouEzzeddine
1From the Division of Cardiovascular Diseases (S.F.M., I.H., O.F.A.E., H.T., S.H.K., V.L.R., M.M.R.), Mayo Graduate School (S.F.M.), and Department of Health Sciences Research (V.L.R.), Mayo Clinic, Rochester, MN; and Division of Cardiovascular Medicine, Temple University, Philadelphia, PA (P.F.). mohammed.selma@mayo.edu.
Circulation
|November 14, 2014
まとめ
右心室シストリック機能不全 (RVD) は,保存されたエジェクション分数 (HFpEF) 患者の心不全において一般的であり,より高い死亡率と入院率を含む,より悪い結果を予測します. この発見は,HFpEF管理におけるRVDの臨床的重要性を強調しています.
科学分野:
- 心臓病学 心臓病学
- エコーカルディオグラフィー エコーカルディオグラフィー
- 心不全に関する研究
背景:
- 右心室シストリック機能不全 (RVD) の罹患率と保存されたエジェクション分数 (HFpEF) による心不全における有意性は不明である.
- HFpEFは重要な患者集団に影響を与え,貢献する要因と予後指標をよりよく理解する必要がある.
研究 の 目的:
- コミュニティベースのHFpEFコホートにおけるRVDの有病率と臨床的重要性を特徴付ける.
- RVDと臨床的特徴,エコーカルディオグラフィの発見,患者のアウトカムとの関連を決定する.
主な方法:
- フレミングハム基準を満たした562人のHFpEF患者 (エジェクション分数 ≥50%) の見込みの特定.
- 診断とフォローアップのエコーカルディオグラフィは,三環状平面シストリックエクスクルションと半量的な2D評価を使用してRV機能を評価します.
- 特定原因による死亡率とHF入院率の分析,関連する共変数で調整.
主要な成果:
- RVDは,HFpEF患者のかなりの割合で特定され,しばしば心房細動,ペースメーカー,および利尿薬の使用と関連していました.
- RVDの患者は,左下心室のエジェクション分数,より悪い透析機能不全,低血圧,より高い肺動脈静脈圧,より重度のRV拡大と三体吐を示した.
- RVDは,使用された定義 (半量的なまたは三角形環状平面シストリックエクスクルシオン) にかかわらず,独立してより高い全因および心血管死亡率,およびHF入院率の増加を予測しました.
結論:
- 右心室シストリック機能不全は,コミュニティベースのHFpEF患者で頻繁に発見されます.
- RVDは,より高度なHF特性に関連しており,より悪い予後を予告します.
- RV機能の評価は,HFpEFのリスク分層化と管理に不可欠です.
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