与功能性三回相关的过度死亡,并发性心力衰竭与减少喷射率
Giovanni Benfari1,2, Clemence Antoine1, Wayne L Miller1
1Division of Cardiovascular Disease, Mayo Clinic, Rochester, MN (G.B., C.A., W.L.M., P.T., Y.T., H.I.M., S.P., M.E.-S.).
Circulation
|May 24, 2019
概括
功能性三回 (FTR) 在心力衰竭中常见,并且与生存率下降有关. 在这些患者中,更高的FTR严重程度显著增加了死亡风险.
科学领域:
- 心脏病学
- 心声检查
- 心脏衰竭的研究
背景情况:
- 功能性三回 (FTR) 在心力衰竭中普遍存在.
- 在HFrEF中FTR的临床意义尚未完全理解.
- 在HFrEF患者中,FTR通常是肺高血压的次要症状.
研究的目的:
- 研究FTR在HFrEF患者中的临床影响和预后影响.
- 在大型HFrEF队列中确定FTR严重程度与总死亡率之间的关联.
主要方法:
- 从2003年至2011年对13026名梅奥诊所患者的HFrEF (排泄分数<50%) 的回顾性分析.
- 通过多普勒心声学估计的FTR分级和静脉脉压.
- 分析了整体死亡率,对临床和心声学因素进行调整;除了心脏起器,之前的门手术或有机门疾病.
主要成果:
- 在88%的患者中检测到FTR;轻度 (32%),中度 (17%) 和重度 (6%) 的FTR独立地与死亡率增加有关.
- 较高的FTR严重程度与呼吸障碍增加,功能受损和心脏输出量降低相关.
- 随着FTR严重程度的增加,五年生存率显著下降:68% (微不足道) 至34% (严重).
结论:
- 在HFrEF中,FTR很常见,并与肺高血压和心房有关.
- 增加FTR严重程度是HFrEF长期生存的独立预测因素.
- 鉴于其对HFrEF结果的负面影响,针对FTR治疗的临床试验是合理的.
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