心力衰竭持续时间对晚期心力衰竭中肺高血压的发展的重要性
Freja Pust1, Tania Deis1, Johan Larsson1
1Department of Cardiology, Rigshospitalet, Copenhagen, Denmark.
International journal of cardiology
|August 21, 2023
概括
心力衰竭的持续时间与晚期病例中肺血管抵抗力 (PVR) 的增加有关. 然而,在详细分析中,这种关联会消失,这表明仅仅持续时间并不能排除心脏移植评估.
科学领域:
- 心脏病学 心脏病学
- 肺高血压是什么意思 肺高血压
- 心脏衰竭管理的管理
背景情况:
- 肺血管阻力 (PVR) 是高级心力衰竭 (HF) 治疗候选症的一个关键指标.
- 在HF患者中,PVR升高的危险因素尚未得到广泛研究.
研究的目的:
- 调查心力衰竭持续时间与PVR升高之间的关联.
- 确定PVR对晚期HF患者长期死亡率的影响.
主要方法:
- 对549名经过右心导管治疗的晚期心肺炎患者的回顾性分析.
- 回归分析以评估HF持续时间和PVR之间的关系.
- 考克斯的比例危险和卡普兰-梅尔对PVR和死亡率的分析.
主要成果:
- 单变量分析显示,较长的HF持续时间与增加的PVR相关 (p=0.014).
- 在17%的患者中观察到升高的PVR (>3 WU),与年龄较大和更长的HF持续时间有关.
- 在多变量分析中,HF持续时间无法预测PVR>3 WU (OR 1.00,p=0.99).
- 增加PVR显著与更高的全因死亡风险相关 (aHR为1.24,p<0.001).
结论:
- 虽然单变量分析表明存在联系,但多变量分析表明,仅仅高频持续时间无法独立预测升高的PVR.
- 升高的PVR是晚期HF死亡率的重要预测因素.
- HF持续时间不应该阻碍先进治疗的候选人,如心脏移植.
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