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在没有左心室缩功能障碍的情况下,心力衰竭与超性心肌病的进展到终端阶段之间的比较

Shoko Nakagawa¹, Atsushi Okada¹, Yuki Irie¹

¹Department of Heart Failure and Transplantation, National Cerebral and Cardiovascular Center.

Circulation journal : official journal of the Japanese Circulation Society

|June 23, 2024

概括

没有左心室静脉缩功能障碍的心力衰竭在高性心肌病患者中比发展或突然心脏死亡更为常见. 这些条件有不同的预测因素和最小的重叠.

科学领域:

心脏病学心脏病学
心血管研究研究心血管研究
超性心肌病研究超性心肌病研究

背景情况:

在没有左心室缩功能障碍 (LVSD) 的高性心肌病 (HCM) 中的心力衰竭 (HF) 缺乏明确的理解.
在没有LVSD的情况下,HF的预测因素,LVSD的进展,以及HCM中的突然心脏死亡 (SCD) 尚未完全阐明.

研究的目的:

调查HCM患者在没有LVSD的情况下住院治疗HF的发生率和预测因素.
将这些结果与LVSD和SCD的发展进行比较.
在HCM中确定不同高频轨迹的独特风险因素.

主要方法:

对330名HCM患者的回顾性分析,左心室喷射率 (LVEF) ≥50%.
评估没有LVSD的HF住院治疗和LVSD的发展作为主要结局.
多变量分析以确定每个结果的预测因子,在中位数为7.3年的随访期间.

主要成果:

没有LVSD的HF住院发生在18.8%的患者中,高于发展LVSD (10.9%) 或SCD (8.8%).
只有19.4%的患有LVSD的患者在没有LVSD的情况下先前接受过HF住院治疗.
没有LVSD的HF预测因素 (年龄,心房动,先前的HF,BNP) 与发展LVSD的预测因素 (男性性别,较低的LVEF,较低的LVOT梯度,较高的TR梯度) 显著不同.

结论:

在LVEF≥50%的HCM患者中,没有LVSD的HF住院比发展LVSD或SCD更频繁.
没有LVSD的HF与LVSD进展之间的重叠是有限的.
没有LVSD的HF和在HCM中发展LVSD具有不同的临床预测因子.

关键词:

扩展阶段的扩展阶段 HFpEF HFpEF 的意思是什么心力衰竭与保存的喷射分数的心脏衰竭预后预后预测预测突然死亡是突然死亡.

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