在心力衰竭中,心房肌病和缺血性中风具有保存的喷射分数
Kassem Farhat1, Khaled Elkholey1, Zain Ul Abideen Asad1
1Cardiovascular Section, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
The American journal of cardiology
|July 28, 2023
概括
心房肌病,一种影响心脏的疾病.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 内部医学 内部医学
背景情况:
- 最近的研究表明,心房肌病与中风有关,即使没有心房动 (AF).
- 患有心力衰竭和保留射出分数 (HFpEF) 的患者是了解中风风险因素的关键人群.
- 在HFpEF患者中,心房肌病和缺血性中风之间的关系需要进一步调查.
研究的目的:
- 检查HFpEF患者中心房肌病和缺血性中风之间的关联.
- 为了测试心房肌病增加中风风险的假设,在这个队列中独立于心房动.
主要方法:
- 对TOPCAT试验的探索性后期分析.
- 包括那些没有先前AF诊断的鼻节律患者.
- 通过心声图 LA 扩大或升高的 natriuretic 的确定的心房肌病.
- 使用考克斯回归来评估发生性缺血性中风的风险.
主要成果:
- 在34.0%符合条件的患者中存在心房肌病 (n=756/2225).
- 心房肌病与缺血性中风风险增加1.74倍相关 (HR 1.74;95% CI 1.01-2.98;p=0.04).
- 糖尿病是中风的唯一其他独立预测因子 (HR2.02;95% CI 1.19-3.43;p=0.01).
结论:
- 心房肌病是患有HFpEF和鼻节律的患者中缺血性中风的独立预测因素.
- 这些发现凸显了心房肌病在HFpEF患者中风风险分层中的重要性.
- 需要进一步的研究来阐明机制,并制定有针对性的中风预防策略.
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