在HFrEF患者群体中,心力衰竭的发病率和预测因子与改善的射出分数类别
Balázs Solymossi1, Balázs Muk1, Róbert Sepp2
1Gottsegen National Cardiovascular Center, Budapest, Hungary.
ESC heart failure
|December 21, 2023
概括
大约20%的心力衰竭患者减少排气分数 (HFrEF) 患者在一年内改善到心力衰竭改善排气分数 (HFimpEF). 关键预测因素包括女性性别,非缺血病原因和较小的心室尺寸.
科学领域:
- 心脏病学 心脏病学
- 心脏衰竭研究研究
背景情况:
- 减少喷射分数 (HFrEF) 的心力衰竭是一个重大的临床挑战.
- 一部分HFrEF患者可以过渡到改善的喷射分数 (HFimpEF).
- 了解这种过渡的发生率和预测因素对于患者管理至关重要.
研究的目的:
- 在一组HFrEF患者中确定发展心力衰竭与改善射出分数 (HFimpEF) 的1年发生率.
- 确定与这种改进相关的预测因素.
- 分析HFrEF诊断和HFimpEF发展以来的时间之间的关系.
主要方法:
- 匈牙利心力衰竭登记处 (HHFR) 的833名HFrEF患者的回顾性分析.
- 在1年的随访期内评估HFimpEF发展情况.
- 单变量和多变量逻辑回归分析以确定预测因素.
主要成果:
- 一年内HFimpEF的发病率为19.5% (162/833名患者).
- 总人口中HFimpEF发展的独立预测因素是女性性别,非缺血病病因和左心室末端透气直径 (LVEDD) <60毫米.
- 随着HFrEF诊断时间的延长,HFimpEF的发病率下降 (27.1%在3个月内 vs. 12.2%在1年后).
结论:
- 在门诊环境中,大约20%的HFrEF患者在1年内实现了HFimpEF.
- 女性性别,非缺血性病因,更窄的QRS宽度,以及较小的左心室和心房直径是HFimpEF的显著预测因素.
- 早期诊断HFrEF与随后HFimpEF发展的更高发病率有关.
更多相关视频
相关概念视频
01:17Pathophysiology of Heart Failure
1.6K
Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
1.6K
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
436
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
436
01:22Heart Failure Drugs: β-Blockers
341
β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation,...
341
01:22Heart Failure Drugs: Diuretics
394
Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
394
01:26Imbalances in Cardiac Output
1.4K
The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
1.4K