与心力衰竭相关的临床,心声和纵向特征与改善的射出分数
Erick Romero1, Alexander Francois Baltodano2, Paulo Rocha1
1Division of Cardiovascular Medicine, UC Davis Medical Center, Sacramento, California.
The American journal of cardiology
|November 3, 2023
概括
近40%的心力衰竭患者减少了喷射分数 (HFrEF) 患者改善了喷射分数 (HFimpEF). 性别,种族和并发症等因素预测了这种改善,这与更好的生存率有关.
科学领域:
- 心脏病学 心脏病学
- 心脏衰竭研究研究
- 临床结果 临床结果
背景情况:
- 改善喷射分数 (HFimpEF) 的心力衰竭表明预后比减少喷射分数 (HFrEF) 的心力衰竭更好.
- 从HFrEF过渡到HFimpEF的预测因素尚未得到充分理解.
- 识别这些因素对于改善患者护理和治疗结果至关重要.
研究的目的:
- 在最初被诊断为HFrEF的患者队列中调查与HFimpEF发展相关的临床和纵向特征.
- 确定能够区分过渡到HFimpEF的患者与持久HFrEF的患者的预测因素.
主要方法:
- 一个单一中心的HFrEF队列 (2014-2022) 的回顾性分析.
- 纳入标准:ICD代码,心声回声数据和尿水平.
- 终点:HFimpEF (EF>40%与≥10%的增加) 和死亡率.
- 统计分析:Cox比例危险和混合效应模型.
主要成果:
- 在1,307名HFrEF患者中,38.7%的患者在16.3个月的中位随访时间内过渡到HFimpEF.
- 多变量分析揭示了性别,种族,并发症,心声学参数和尿水平作为HFimpEF的显著预测因素.
- 与持久性HFrEF组相比,HFimpEF组表现出明显更好的生存率 (p < 0.001).
结论:
- 很大一部分HFrEF患者可以过渡到HFimpEF,通常是在第一年内.
- 结合人口,临床,心声和生物标志物数据的预测模型可以识别患有持续HFrEF或HFimpEF风险的患者.
- 该模型可以指导有针对性的干预措施,以提高心力衰竭患者的护理质量.
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