在心力衰竭中右心室功能与保存的喷射分数:一个基于社区的研究
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
概括
右心室缩功能障碍 (RVD) 在心力衰竭中很常见,其中包括保留喷射小部分 (HFpEF) 患者,并且预测了更糟糕的结果,包括更高的死亡率和住院率. 这一发现强调了RVD在HFpEF管理中的临床意义.
科学领域:
- 心脏病学 心脏病学
- 心声回声扫描 (Echocardiography) 是一种心声回声扫描.
- 心脏衰竭研究研究
背景情况:
- 右心室缩功能障碍 (RVD) 的患病率和心力衰竭与保留喷射分数 (HFpEF) 的意义仍然不清楚.
- 高高压pEF影响了大量患者群体,因此需要更好地了解导致因素和预后指标.
研究的目的:
- 在基于社区的HFpEF队列中描述RVD的患病率和临床意义.
- 确定RVD与临床特征,心声学发现和患者结局的关联.
主要方法:
- 预期识别562名符合弗雷明汉标准的高高度皮质突患者 (排泄分数≥50%).
- 在诊断和随访时进行心声回声,以评估RV功能,使用三状环状平面缩外流和半定量二维评估.
- 分析因特定原因死亡率和HF住院率,根据相关共变量进行调整.
主要成果:
- 在相当大比例的高高压脑动症患者中发现了RVD,通常与心房动,心脏起器和利尿剂使用有关.
- 患有RVD的患者表现出左下心室喷射分数,更严重的透析功能障碍,更低的血压,更高的肺动脉静脉压,以及更严重的RV扩大和三回.
- RVD独立地预测了较高的全因和心血管死亡率,以及不论使用的定义 (半定量或三环状平面缩外流) 如何,都增加了HF住院率.
结论:
- 右心室缩功能障碍是社区HFpEF患者经常发现的发现.
- RVD与更先进的高频特征有关,预示着更差的预后.
- 评估RV功能对于风险分层和HFpEF管理至关重要.
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