右心室扩张性功能障碍使日本心力衰竭患者的临床结果恶化
Daisuke Harada1, Takahisa Noto1, Junya Takagawa1
1The Cardiology Division, Imizu Municipal Hospital, Toyama, Japan.
International journal of cardiology. Heart & vasculature
|November 13, 2023
概括
由状静脉脉冲波形识别的右心室扩张功能受损,是日本心力衰竭患者不良结果的重要预测因素. 这一发现独立于左心室喷射分数,突出了其在治疗心力衰竭方面的重要性.
科学领域:
- 心脏病学 心脏病学
- 老年病的医生 老年病的医生
- 公共卫生 公共卫生
背景情况:
- 心力衰竭 (HF) 在老年人群中构成了越来越大的挑战,特别是在日本.
- 右心力衰竭 (RHF) 在老年HF患者中很普遍.
- 了解右心室 (RV) 透析功能的预后影响对于管理HF结果至关重要.
研究的目的:
- 调查右心室透静功能障碍与日本心力衰竭患者不良临床结果之间的关联.
- 为了识别特定的心声回声和静脉脉冲 (JVP) 波形特征,表明RV扩张性损伤.
- 为了确定HF中心脏事件的RV透气功能的独立预测值,HF.
主要方法:
- 对387名日本高温肺炎患者的回顾性分析,这些数据来自心声学,JVP和医疗记录.
- 使用JVP波形分析识别一个不太可伸缩的RV (比"X"下降更深的"Y"下降).
- 定义心脏事件,包括突然死亡,HF死亡,紧急利尿疗法和HF住院治疗;采用多变量Cox比例危险建模.
主要成果:
- 与没有事件的患者相比,患有心脏事件的患者表现出左下心室喷射率 (LVEF),较高的 mitra E / e' 和较少扩张的 RV 的更高流行率.
- 在64%的患有心脏病事件的患者中,鉴定出一种不太可伸缩的RV,而在没有心脏病事件的患者中,这一比例为27% (p < 0.001).
- 多变量分析显示LVEF和不太容易膨胀的RV是心脏事件的独立风险因素 (HR:RV为3.150,p<0.001).
结论:
- 右心室扩张功能受损,以不太容易膨胀的RV为特征,是日本HF患者不良临床结果的重要独立预测因素.
- 即使在维护或中度降低LVEF的患者中,RV透析功能障碍的预后影响也可能持续存在.
- 这些发现表明,评估RV透气功能对于预测和管理老年人群中难治性HF至关重要.
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