非心脏伴随性疾病对慢性心力衰竭中运动能力和功能状态的明显影响
Pieter Martens1, Silvio N Augusto2, J Emanuel Finet1
1Kaufman Center for Heart Failure Treatment and Recovery, Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA.
JACC. Heart failure
|June 30, 2023
概括
非心脏并发症 (NCC) 显著影响心力衰竭 (HF) 患者. 管理各种NCC对于改善慢性HF的运动能力和患者结果至关重要.
科学领域:
- 心脏病学 心脏病学
- 运动生理学 运动生理学
- 老年学是一门学科.
背景情况:
- 非心脏并发症 (NCC) 在心力衰竭 (HF) 患者中很普遍.
- 对于HF患者的运动能力和功能状况,NCC的综合影响仍未得到充分研究.
研究的目的:
- 研究NCC对慢性心力衰竭 (HF) 运动能力和功能状态的累积影响.
- 为了确定NCC负担,HF类型和临床结果之间的关联.
主要方法:
- 在多个HF临床试验 (HF-ACTION,IRONOUT-HF,NEAT-HFpEF,INDIE-HFpEF,RELAX-HFpEF) 中评估了基线NCC状态.
- 评估了与峰值氧气吸收 (Vo2),6分钟步行测试 (6MWT),堪萨斯城心肌病问卷 (KCCQ) 和全因死亡率的关系.
- 利用集群分析,根据不同的NCC个人资料将患者分组.
主要成果:
- 总共分析了2,777名患者,揭示了HF中较高的NCC负担,其中保留了喷射分数.
- 肥胖症显著限制了HF中的峰值Vo2和6MWT,并保留了射出分数.
- 增加的NCC负担与峰值Vo2,6MWT和KCCQ分数的下降相关.
- 集群分析确定了三个不同的NCC组,肥胖和糖尿病 (集群3) 显示最糟糕的功能状态和运动反应.
- 集群2 (慢性脏病,外周血管疾病) 与集群1 (中风,癌症) 相比,具有更高的全因死亡风险.
结论:
- 慢性HF患者的NCC类型和负担累积和显著影响慢性HF患者的运动能力.
- 确定了与特定临床结果相关的NCC的独特集群.
- 研究结果强调了解决多方面的NCC对于优化HF管理和患者预后的重要性.
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