估计的血体积状况为晚期心力衰竭中血液动力学参数增加了预后价值
Yihang Wu1, Pengchao Tian1, Lin Liang1
1Heart Failure Center, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.167 Beilishi Road, Xicheng District, Beijing, 100037, China.
Internal and emergency medicine
|September 21, 2023
概括
估计的血体积状态 (ePVS) 在先进的心力衰竭中提供预后价值,独立于血液动力学拥堵. 高的ePVS独立预测死亡率,改善了心力衰竭患者的风险预测模型.
科学领域:
- 心脏病学 心脏病学
- 心脏衰竭研究研究
- 临床预后 临床预后
背景情况:
- 估计血体积状态 (ePVS) 是对血管内血栓塞和心力衰竭 (HF) 预后的公认标志物.
- 升高的心内填充压力定义了血液动力学拥堵,也与糟糕的结果有关.
- 血管内堵塞 (ePVS) 和血液动力阻塞之间的直接关系尚未得到充分证实.
研究的目的:
- 在晚期HF患者中研究ePVS和血液动力学参数之间的相关性.
- 确定ePVS与临床结果之间的关联,特别是全因死亡率.
主要方法:
- 进行了右心导管术 (RHC),以评估晚期HF患者的血液动力学概况.
- 血液动力学拥堵被定义为右心房压力和肺动脉压力>30 mmHg的总和.
- 使用施特劳斯衍生的杜阿尔特公式计算ePVS,该公式是从RHC发生后24小时内的血液检测中得出的.
主要成果:
- 患有ePVS>4.08dL/g的患者表现出更高的湿率和明显增加的全因死亡风险 (HR 4.748).
- 血液动力学参数和ePVS之间没有发现显著的相关性.
- 高的ePVS提高了联合临床和血液动力学预后模型的预测值 (AUC 0.844).
结论:
- 在先进的心力衰竭中,ePVS提供了额外的预后价值,超出了既定的血液动力学参数.
- 尽管缺乏与血液动力学拥堵的相关性,但ePVS独立预测了这一患者群的死亡率.
- ePVS是完善先进高频风险分层的宝贵工具.
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