一种简单的,以证据为基础的方法来帮助指导心力衰竭的诊断
Yogesh N V Reddy1, Rickey E Carter2, Masaru Obokata1
1Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN (Y.N.V.R., M.O., M.M.R., B.A.B.).
Circulation
|May 25, 2018
概括
新的H2FPEF评分有助于诊断呼吸障碍患者的心力衰竭与保存的喷射分数 (HFpEF). 该评分使用临床因素和心声回声学来提高诊断准确度,并指导进一步的测试.
科学领域:
- 心脏病学
- 诊断医学
- 医学研究
背景情况:
- 诊断心脏衰竭与保存的喷射分数 (HFpEF) 在患有呼吸障碍的患者是临床上的挑战.
- 目前,该患者群体中没有基于证据的HFpEF诊断标准.
- 这项研究旨在制定和验证非侵入性标准,以估计患者的HFpEF概率.
研究的目的:
- 开发和验证一种新型的非侵入性评分系统,用于诊断心力衰竭与保存的喷射分数 (HFpEF).
- 帮助临床医生识别可能有HFpEF的不明原因呼吸障碍患者,指导后续诊断评估.
- 与现有方法相比,提高HFpEF的诊断准确性.
主要方法:
- 对连续出现不明原因呼吸障碍的患者进行回顾性评估,并推进行侵入性血液动力学运动测试.
- 通过侵入性血液动力学运动测试证实了HFpEF与非心脏性呼吸障碍的诊断.
- 使用后勤回归来确定预测性临床变量,从而在单独的队列中开发和验证H2FPEF得分.
主要成果:
- H2FPEF评分包括肥胖,心房动,年龄大于60岁,≥2种抗高血压药物,E/ e'比率大于9,肺动脉静脉压大于35mmHg.
- 该得分显示了HFpEF的强烈区分能力 (AUC为0. 841在导出中,0. 886在验证中).
- H2FPEF得分显著优于目前的专家共识算法.
结论:
- 使用简单的临床和心声学数据的H2FPEF得分有效地区分HFpEF与非心脏性呼吸障碍.
- 这一分数可以帮助确定患者是否需要进一步的诊断检查.
- H2FPEF评分为改善HFpEF诊断提供了一种实用工具.
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