从查和健康状况的诊断收益负担的门诊患者有心力衰竭的风险
Omar Cantu-Martinez1,2, Andrew A Girard1,2, Weiwei Jin3,4
1University of Missouri - Kansas City's Healthcare Institute for Innovations in Quality, Kansas City, MO.
medRxiv : the preprint server for health sciences
|March 10, 2025
概括
查心力衰竭 (HF) 风险的初级保健患者,使用非侵入性左心室末腹压 (LVEDP) 确定近40%的患者患有升高的LVEDP. 许多患者表现出严重的健康损害,这表明需要进一步评估HF.
科学领域:
- 心脏病学 心脏病学
- 初级医疗保健医学 一级医疗保健医学
- 诊断查 诊断查 诊断查 诊断查
背景情况:
- 由于非特异性症状和不频繁的查,心力衰竭 (HF) 在初级保健中往往被诊断不足.
- 这导致患者被诊断为晚期疾病,影响他们的生活质量和功能能力.
研究的目的:
- 评估查高风险门诊患者的有效性,使用左心室末端透气压 (LVEDP) 的非侵入性测量.
- 通过这种查方法,鉴定出患有高LVEDP的患者的健康状况.
主要方法:
- 选了患有糖尿病 (DM),慢性病 (CKD) 或怀疑HF的成年人的方便样本.
- 维维奥系统用于非侵入性LVEDP评估,积极查被定义为LVEDP>18 mmHg.
- 使用堪萨斯城心肌病问卷总体总结 (KCCQ-OS) 评分对具有阳性查结果的患者进行健康状况评估.
主要成果:
- 在2040名查患者中,38.5%的LVEDP升高.
- 年龄较大,女性性别和CKD存在与LVEDP升高的可能性较高有关 (p<0.01).
- 在653名KCCQ-OS得分的患者中,31.4%无症状 (KCCQ-OS=100),而26.5%的得分小于80,表明NYHAII-IV类症状.
结论:
- 非侵入性LVEDP查发现了相当一部分高危初级保健患者的LVEDP升高.
- 超过三分之二的阳性查患者报告了显著的健康状况下降.
- 将非侵入性LVEDP评估与KCCQ评分相结合,可以帮助识别可能受益于进一步心力衰竭评估的患者.
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