肥胖改变了右心室功能障碍的临床结果
Janet I Ma1, Emily K Zern2, Juhi K Parekh3
1Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston (J.I.M., E.P., M.H.P.).
Circulation. Heart failure
|October 27, 2023
概括
肥胖会恶化右心室 (RV) 功能障碍及其与死亡率和心力衰竭的关联. 较高的体重指数会放大VR功能障碍对患者结果的不良影响.
科学领域:
- 心脏病学 心脏病学
- 心血管疾病 心血管疾病
- 肥胖医学 肥胖医学
背景情况:
- 右心室 (RV) 功能障碍是各种心血管疾病死亡率的已知预测因素.
- 肥胖对VR功能障碍和随后的临床结果的具体影响仍然不完全理解.
研究的目的:
- 为了研究肥胖和VR功能障碍的血液动力学指数之间的关联.
- 检查RV功能和肥胖如何相互作用以影响临床结果,如死亡率和心力衰竭住院治疗.
主要方法:
- 分析了2005年至2016年间接受右心导管治疗的8285名患者的医院队列.
- 线性回归评估了体质指数和RV功能障碍指数之间的关系 (例如,肺动脉脉动指数,右心房压力:肺毛细血管压率,RV中风工作指数).
- 考克斯模型评估了RV功能测量与死亡率和心力衰竭住院的关联,并对体重指数进行了相互作用分析.
主要成果:
- 较高的体重指数与较差的RV功能指数相关,包括下肺动脉脉动力指数和RV中风工作指数,以及较高的右心房:肺毛细血管压比 (所有人P<0.001).
- 在7.3年的中位数随访期间,RV功能障碍与增加的死亡率和心力衰竭住院病例有关.
- 体重指数显著改变了VR功能障碍和全因死亡率之间的关联,体重指数水平较高的风险更明显 (P相互作用≤0.005).
结论:
- 肥胖与RV功能的血液动力学测量受损有关,在一个大型的医院基队列中.
- RV功能障碍独立预测不良临床结果,包括死亡率和心力衰竭住院治疗.
- RV功能障碍的不良预后影响在身体质量指数较高的人群中显著放大,突出显示肥胖是心血管风险分层的一个关键因素.
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