通过心室缩和腹缩功能的患者结果
Jacqueline Levene1, Andrew Voigt1, Floyd Thoma1
1Heart and Vascular Institute at the University of Pittsburgh School of Medicine Pittsburgh PA USA.
Journal of the American Heart Association
|February 14, 2024
概括
左心室扩张功能障碍 (DD) 显著增加了心力衰竭住院和死亡的风险,特别是在减小喷射率 (EF) 的患者中. 即使没有缩功能障碍,严重的DD也会造成心脏骤停的风险,与中度缩功能障碍相当.
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:
- 左心室功能障碍包括静缩和静缩参数,导致心力衰竭,减少或保留射出分数.
- 了解心和腹功能障碍的不同和重叠的影响对于患者管理至关重要.
研究的目的:
- 调查左心室缩和腹功能障碍对患者死亡率和住院事件的影响.
- 为了比较透支功能障碍的预后影响,在不同的喷射分数水平上进行分级.
主要方法:
- 分析了两个队列:A队列 (EF ≥50%) 按腹功能障碍等级分层,B队列 (EF <50%) 按EF四分位数分层.
- 对所有死因,心血管,心力衰竭和心脏骤停住院治疗的长度随访.
- 为了评估独立的风险关联,对并发症进行统计调整.
主要成果:
- 所有原因的死亡率和心血管/心力衰竭住院的风险增加与保存EF中的更高的扩张功能障碍等级相关,并且在EF恶化时更明显.
- 严重的 (III级) 透支功能障碍呈现出心脏骤停住院的风险,与排气分数<25%相当.
- 扩张功能障碍带来了显著的风险,特别是在心脏骤停事件中,即使是在保留喷射分数的患者中也是如此.
结论:
- 虽然缩功能障碍导致整体死亡率和心力衰竭住院的风险更高,但严重的腹功能障碍 (II/III级) 造成心脏骤停的风险与中度/严重的缩功能障碍相当.
- 扩张功能障碍是不良心血管事件的独立预测因素,包括心脏骤停.
- 进一步研究扩张性功能障碍的向治疗策略是有必要的,以改善患者的治疗结果.
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