在心肌梗塞之后,左心室喷射小部分保留或轻微减少的患者的透气功能障碍和生存率
Nicole Ivy Chan1, John J Atherton2, Anish Krishnan1
1Department of Cardiology, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
概括
扩张性功能障碍 (DD) 显著预测心肌梗塞 (MI) 后的心脏病发作 (MI) 患者的死亡率. 这一发现重新分类了预后在一个组,其中喷射分数单独是不足以进行风险评估.
科学领域:
- 心脏病学 心脏病学
- 心声回声扫描 (Echocardiography) 是一种心声回声扫描.
- 临床结果 临床结果
背景情况:
- 左心室喷射分数 (LVEF) 是心肌梗塞 (MI) 患者的不良预后指标,LVEF 保持或轻微减少 (>40%).
- 基于指导方针的扩张性功能障碍 (DD) 评估可能会在这个患者亚组中提供更好的预后价值.
研究的目的:
- 评估基于指导方针的扩张性功能障碍 (DD) 对长期死亡率的预测价值.
- 为了确定DD是否重新分类心脏病发作患者的预后,这些患者的LVEF保持或轻微减少 (>40%).
主要方法:
- 对2,234名第一次心脏病发作和LVEF>40%的患者进行了回顾性分析.
- 收集的数据包括临床,血管和心声学参数.
- 显著的DD定义为2级和3级DD,评估在入院后的早期.
主要成果:
- 14.1%的患者有显著的DD.
- 在平均4.5年的随访期内,显著的DD独立预测了全因死亡率 (HR=2.01) 和心脏死亡率 (HR=3.97).
- 多变量分析和统计验证证实了DD与结果的独立关联.
结论:
- 显著的扩张功能障碍是保持或轻微减少LVEF的患者中心脏病后死亡率的独立预测因子.
- DD有效地重新分类患者的预后,而LVEF则是无差别的.
- 需要进一步研究该队列中DD的临床影响和治疗策略.
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