体重变化对心力衰竭患者长期死亡率的影响
Nuno Melo1, Ana I Ferreira1, Clara Silva1
1Internal Medicine Department, Centro Hospitalar e Universitário de São João, 4200-319 Porto, Portugal.
Archives of cardiovascular diseases
|August 13, 2023
概括
心力衰竭患者的体重减轻预示着不良结果,但不是肥胖个体. 这表明减肥对肥胖心力衰竭患者来说可能是安全的,这与普遍的预期相反.
科学领域:
- 心脏病学 心脏病学
- 内部医学 内部医学
- 临床研究 临床研究
背景情况:
- 心力衰竭的预后通常与减肥有关.
- 肥胖心力衰竭患者体重变化的影响仍未得到充分研究.
研究的目的:
- 调查不同体重指数 (BMI) 层中心力衰竭患者体重变化和死亡率之间的关联.
主要方法:
- 对589名慢性心力衰竭患者的回顾性分析,左心室喷射率<50%和≥1年的随访.
- 患者按1年体重变化 (>5%增加,>5%减轻,稳定) 分类.
- 考克斯回归分析用于确定体重变化的预后影响.
主要成果:
- 体重减轻 (>5%) 与死亡风险增加有关 (HR 1.61).
- 这种关联在低/正常体重 (HR 1.81) 和超重 (HR 2.34) 患者中仍然显著.
- 患有>5%体重减轻的肥胖患者没有增加死亡风险 (HR 1.08).
结论:
- 减肥预测非肥胖心力衰竭患者的死亡率更高.
- 显著的体重减轻似乎不会对肥胖心力衰竭患者的生存产生负面影响.
- 在肥胖心力衰竭患者中,不鼓励减肥可能不合理.
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