心力衰竭中的肥胖悖论与轻微减少的射出分数
Marielen Reinhardt1, Tobias Schupp1, Mohammad Abumayyaleh1
1Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Pragmatic and observational research
|March 14, 2024
概括
轻度减排率 (HFmrEF) 的心力衰竭患者的较低体重指数 (BMI) 与较高的死亡风险有关. 这表明一种肥胖悖论,在HFmrEF中,更高的BMI可能是保护性的.
科学领域:
- 心脏病学 心脏病学
- 临床研究 临床研究
- 公共卫生 公共卫生
背景情况:
- 关于身体质量指数 (BMI) 在心力衰竭患者中具有轻微减少喷射率 (HFmrEF) 的预后意义的数据有限.
- 了解BMI的作用对于风险分层和HFmrEF患者的管理至关重要.
研究的目的:
- 研究BMI对住院HFmrEF患者全因死亡率和再住院的预后影响.
- 探索HFmrEF人群中潜在的"肥胖悖论".
主要方法:
- 在2016年至2022年期间连续住院的1832名HFmrEF患者 (LVEF 41-49%) 的回顾性分析.
- 患者被分类为世卫组织定义的BMI组,以进行风险分层.
- 主要终点:使用卡普兰-梅尔和考克斯回归模型分析的30个月全因死亡率.
主要成果:
- 与较高的BMI组相比,BMI最低 (18.5-24.9 kg/m2) 的患者表现出30个月全因死亡率 (40.0%) 的最高风险.
- 在多变量调整后,更高的BMI值独立地与改善的30个月生存率 (HR=0.963,p=0.001) 相联系.
- 体重指数没有显著影响30个月心力衰竭相关再住院的风险 (p=0.064).
结论:
- 在住院的HFmrEF患者中,较低的BMI与30个月全因死亡率的风险增加有关.
- 研究结果表明,HFmrEF中存在潜在的肥胖悖论,更高的BMI可能会给生存带来好处.
- 需要进一步的研究来阐明这种关联的机制和临床影响.
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