心脏衰竭患者的身体组成和生存时间:系统性审查和元分析
Dayana D Mendonça1, William V R da Silva2, Gabriela C Souza3
1Post-Graduate Program in Cardiology and Cardiovascular Sciences of the Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
JACC. Heart failure
|April 3, 2025
概括
在心力衰竭 (HF) 患者的低肌肉质量显著增加死亡风险. 身体组成,特别是肌肉消耗,对于HF预后至关重要,而脂肪质量与生存结果没有显著的关联.
科学领域:
- 心脏病学 心脏病学
- 身体组成分析 身体成分分析
- 预测生物标志物 预测生物标志物
背景情况:
- 身体成分越来越被认为是影响心力衰竭 (HF) 预后的关键因素.
- 肌肉质量,无脂肪质量和脂肪质量的变化可能会影响生存,但确切的关联需要澄清.
研究的目的:
- 系统地评估各种身体组成参数对被诊断为心力衰竭患者的生存结果的影响.
- 综合现有队列研究的证据,以量化高频体内身体组成的预后意义.
主要方法:
- 进行了对队列研究的系统审查和元分析,搜索了5个数据库,直到2024年1月.
- 所有原因的死亡率是主要结果,偏差风险使用纽卡斯尔-太华尺度进行评估.
- 使用随机效应模型计算危险比率 (HR) 和95%置信区间 (CI),评估与科克兰的Q和I2统计数据的异质性.
主要成果:
- 分析包括39项队列研究 (36,176名高风患者),其中21项为定量分析做出了贡献.
- 较低的肌肉质量与所有原因死亡率的增加显著相关 (HR: 1.73 [95% CI: 1.32-2.26]),这一发现在敏感性和子组分析中一致.
- 脂肪量增加 (综合调整HR:0.75 [95%CI:0.26-2.12]) 和腹部脂肪增加与死亡风险没有显著关联.
结论:
- 身体组成参数,特别是肌肉质量,与心力衰竭患者的全因死亡率密切相关.
- 肌肉衰竭,以低肌肉质量为标志,是增加死亡率的重要预测因素,强调其在HF预后中的重要性.
- 综合体构成评估,重点是肌肉质量,对于改善心力衰竭管理中的预后评估至关重要.
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