患有心力衰竭的门诊患者的肥胖悖论是真的吗?心力衰竭患者的减排分数是真的吗?
Nathália Felix Araujo Salvino1,2, Lyz Tavares de Sousa3, Fabio Maia Abrahao1
1Serviço e Disciplina de Cardiologia, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.
Frontiers in cardiovascular medicine
|December 27, 2023
概括
肥胖并未被证明是缺血性心力衰竭患者的保护因素,因为缺血性心力衰竭患者的缺血性心力衰竭患者的缺血性心力衰竭患者的缺血性心力衰竭患者的缺血性心力衰竭患者的缺血性心力衰竭患者. 此外,MAGGIC评分也未能预测这一特定患者群体的死亡率.
科学领域:
- 心脏病学 心脏病学
- 代谢障碍 代谢障碍 代谢障碍
- 临床研究 临床研究
背景情况:
- 全球肥胖流行病与心力衰竭 (HF) 预后存在矛盾的关联.
- 现有的研究表明,身体质量和HF结果之间存在复杂的关系.
- 了解这种关联对于有效的患者管理至关重要.
研究的目的:
- 调查身体质量指数 (BMI) 与外科医生患有缺血性心力衰竭与减少喷射率 (HFREF) 的门诊患者的死亡率之间的联系.
- 探索基于BMI的HF功能类别和药理疗法的差异.
- 在这个HFREF群体中评估MAGGIC评分的预后能力.
主要方法:
- 分析了1556个HF门诊病例记录,其中242个符合选择标准.
- 根据BMI对患者的分类:正常 (18.5-24.9),超重 (25-29.9),肥胖类I (30-34.9) 和II (35-39.9).
- 排除BMI<18.5和>40由于有限的数据.
主要成果:
- 体重指数30-34.9和18.5-24.9的患者表现出最好的预后.
- 超重的个体 (BMI 25-29.9) 显示出平均结果.
- 体重指数最高的BMI组 (35-39.9) 呈现出最差的预后 (p=0.123),与BMI 30-34.9 (p=0.033) 相比,发现了显著差异.
- 多变量分析表明,MAGGIC得分无法预测不同BMI类别的死亡率.
结论:
- 在患有缺血性HFREF的门诊患者中,肥胖没有被发现是保护因素.
- 在按BMI分层的特定HFREF人群中,MAGGIC评分对死亡的预后值是有限的.
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