在社区中无症状左心室缩功能障碍的自然史
Thomas J Wang1, Jane C Evans, Emelia J Benjamin
1Framingham Heart Study, Framingham, MA 01702-5827, USA.
Circulation
|August 13, 2003
概括
患有无症状左心室缩功能障碍 (ALVD) 的人面临患上充血性心力衰竭 (CHF) 和死亡的风险明显更高. 这种风险即使在轻度损伤的情况下也存在,这凸显了对最佳治疗方法的进一步研究的需要.
科学领域:
- 心脏病学 心脏病学
- 心血管医学 心血管医学
- 临床研究 临床研究
背景情况:
- 关于患有无症状左心室缩功能障碍 (ALVD) 的人群中充血性心力衰竭 (CHF) 的进展率和死亡率的数据有限.
- 在社区居住的个体中描述ALVD的自然史对于了解疾病进展和结果至关重要.
研究的目的:
- 为了调查无症状左心室缩功能障碍 (ALVD) 的自然史.
- 为了确定患有ALVD的个体进展到充血性心力衰竭 (CHF) 和死亡的速度.
主要方法:
- 对Framingham研究中的4257名参与者进行了分析,这些参与者接受了例行心声回声扫描.
- 评估无症状的左心室缩功能障碍 (ALVD),定义为排气分数 (EF) ≤50%,没有病史的CHF.
- 长度随访长达12年,以追踪心血管疾病和死亡率.
主要成果:
- 在男性中,ALVD的患病率为6.0%,在女性中为0.8%. 在ALVD患者中,CHF的发病率为每100人/年5.8,而在正常人群中为0.7.
- ALVD与心血管衰竭风险增加4.7倍 (调整HR 4.7) 和死亡风险增加1.6倍 (调整HR 1.6) 相关.
- 即使是轻度的ALVD (EF 40-50%) 也显示出心血管衰竭的风险增加了3.3倍,中度至重度的ALVD (EF <40%) 显示出风险增加了7.8倍.
结论:
- 无症状的左心室缩功能障碍 (ALVD) 显著增加了充血性心力衰竭 (CHF) 和社区死亡率的风险.
- 增加的风险是显而易见的,即使在轻微减少喷射分数 (EF).
- 需要进一步的研究,以确定适合轻度ALVD患者的最佳治疗策略.
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