前庭会导致心力衰竭,反之亦然:保留与减少排泄率的时间关联和差异
Rajalakshmi Santhanakrishnan1, Na Wang1, Martin G Larson1
1From Cardiovascular Medicine Section, Department of Medicine (R.S., J.W.M., R.S.V., E.J.B.) and Section of Preventive Medicine and Epidemiology (R.S.V.), Boston University School of Medicine, MA; Data Coordinating Center (N.W.) and Department of Epidemiology (E.J.B.), Boston University School of Public Health, MA; Department of Mathematics and Statistics, Boston University, MA (M.G.L.); National Heart, Lung, and Blood Institute's and Boston University's Framingham Heart Study, MA (M.G.L., J.W.M., S.C., R.S.V., D.L., E.J.B., J.E.H.); Cardiology Division, Department of Medicine, University of Massachusetts Medical School, Boston (D.D.M., E.J.B.); Cardiology Division (S.A.L., P.T.E., J.E.H.) and Cardiovascular Research Center (S.A.L., P.T.E., J.E.H.), Massachusetts General Hospital, Harvard Medical School, Boston; Program in Medical Population Genetics, Broad Institute of Harvard and Massachusetts Institute of Technology, Cambridge (S.A.L., P.T.E.); Division of Cardiology, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.C.); Institute for Clinical Evaluative Sciences and Toronto General Hospital, University of Toronto, ON, Canada (D.S.L.); Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University, Nashville, TN (T.J.W.); and Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, Bethesda, MD (D.L.).
心房 (AF) 和心力衰竭 (HF) 经常同时存在. 这项研究发现AF与射分数保留的HF有更强的联系,并且这两种情况共同增加死亡风险,特别是在射分数减少的HF中.
科学领域:
- 心脏病学
- 临床研究
- 流行病学
背景情况:
- 心房动 (AF) 和心力衰竭 (HF) 经常同时存在,导致预后不佳.
- 需要进一步澄清AF和特定HF亚型 (保留与减少喷射分数) 之间的关系.
研究的目的:
- 调查AF和HF之间的时间关联,特别是检查HF与保留喷射分数 (HFpEF) 与减少喷射分数 (HFrEF) 的差异.
主要方法:
- 在1980年至2012年期间被诊断患有新发性心脏病或心脏病的Framingham Heart Study参与者的分析.
- 使用多变量调整的危险比率 (HR) 和置信区间 (CI) 来评估相关性.
主要成果:
- 在患有新发肌的人中,有37%患有HF;在患有新发肌的人中,有57%患有AF.
- 与发生的HFpEF (HR,2. 34) 相比,FA的流行与HFrEF (HR,1. 32) 的相关性更强.
- 与患有FA的HFpEF患者相比,AF和HF的组合增加了死亡风险,特别是患有FA的HFrEF患者 (HR,2. 72).
结论:
- 在HF患者中,AF非常普遍,而HF在AF患者中很常见.
- AF在HFpEF和HFrEF之前和之后,具有明显的时间关联和预后影响.
- 需要对AF和HF同时发生的机制进行进一步研究.
相关概念视频
Pathophysiology of Heart Failure
Heart Failure II: Pathophysiology
Heart Failure I: Introduction
Heart Failure IV: Classification and Diagnostic Evaluation
Heart Failure V: Medical Management
Heart Failure VI: Adjunct Therapies


