根据身体质量指数,心力衰竭的特定表型与保留/减少的射出分数
Kenichi Matsushita1,2, Kazumasa Harada3, Takahiro Jimba3
1Tokyo CCU Network Scientific Committee, Tokyo, Japan - kenichi-matsushita@umin.ac.jp.
Minerva cardiology and angiology
|February 27, 2025
概括
肥胖悖论,即更高的BMI与更好的存活率相关,在心力衰竭患者中,心力衰竭与保留射出分数 (HFpEF) 比心力衰竭患者中,心力衰竭与减少射出分数 (HFrEF) 更明显. 这项研究根据身体质量指数 (BMI) 确定了不同的患者表型.
科学领域:
- 心脏病学 心脏病学
- 内部医学 内部医学
- 公共卫生 公共卫生
背景情况:
- 身体质量指数 (BMI) 和急性心力衰竭 (HF) 结果之间的关联尚未得到充分理解.
- 现有研究提出了关于BMI对不同HF亚型死亡率的影响的相互矛盾的数据.
研究的目的:
- 为了比较BMI对急性心力衰竭与保存喷射率 (HFpEF) 与急性心力衰竭与减少喷射率 (HFrEF) 的住院死亡率的影响.
- 根据BMI类别定义的特定HFpEF和HFrEF表型的调查.
主要方法:
- 一项针对5313名急性HFpEF和6332名急性HFrEF患者的多中心追溯分析.
- 患者按BMI分类:低 (<18.5),正常 (18.524.9) 和高 (≥25.0,超重/肥胖).
- 卡普兰-梅尔曲线,日志级别测试和考克斯回归分析被用来评估住院死亡率和预后因素.
主要成果:
- 在HFpEF中观察到一个显著的肥胖悖论,更高的BMI与更好的生存率有关.
- 在HFrEF中,发现了较高BMI的较低住院死亡率的趋势,但肥胖悖论不如HFpEF那样明显.
- 在HFpEF和HFrEF队列中,在不同BMI组中确定了不同的临床特征和死亡率预测因素.
结论:
- 肥胖悖论在HFpEF中比HFrEF更明显.
- 按BMI定义的表型揭示了HFpEF和HFrEF种群中独特的临床特征和预后影响.
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