源泉监测人口中的心力衰竭表型生存率,2010-2023年
Lindsey C Ivey1, Cheryl L Raskind-Hood2, Fred H Rodriguez3
1Department of Epidemiology, Emory University Rollins School of Public Health, 1518 Clifton Rd NE, Atlanta, GA, 30322, USA. lcivey@emory.edu.
Pediatric cardiology
|January 8, 2026
概括
患有系统性心力衰竭 (SHF) 的Fontan手术患者面临更糟糕的生存率. 虽然心脏移植可以帮助,但长期结果仍然具有挑战性,需要对这一高风险群体进行更好的风险评估.
科学领域:
- 心脏病学 心脏病学
- 儿童心脏病学 儿童心脏病学
- 遗传性心脏病是一种先天性心脏病.
背景情况:
- 芬坦手术是单心室缺陷的缓解手术.
- 它与包括心力衰竭 (HF) 和死亡率在内的长期并发症有关.
- 了解基于HF表型和移植状态的生存率至关重要.
研究的目的:
- 为了评估Fontan患者的长期生存率.
- 为了比较不同心力衰竭表型 (心缩与非心缩) 的存活率.
- 根据心脏移植状态 (评估,移植或两者都没有) 来评估存活率.
主要方法:
- 确定了722名Fontan患者 (2010-2023) 的队列.
- 用ICD代码对心力衰竭进行分类 (静心性心力衰竭[SHF]和非静心性心力衰竭[NSHF]).
- 使用Kaplan-Meier方法分析了生存率,并与死亡证明联系在一起.
主要成果:
- 与没有HF (2.8%) 或NSHF (6.4%) 的患者相比,SHF患者的死亡率显著更高 (14.0%).
- 移植后的一年,5年和10年的生存率分别为91.7%,74.4%和61.8%.
- 被评估为移植但未移植的患者的1年死亡率为26.6%.
结论:
- 在Fontan患者中,缩性心力衰竭 (SHF) 现型与较差的长期存活率有关.
- 心脏移植可能有好处,但移植后的长期存活是有限的.
- 改善风险分层对于优化这种高风险Fontan人群的移植时间至关重要.
相关概念视频
01:29Heart Failure II: Pathophysiology
704
Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
704
01:17Pathophysiology of Heart Failure
2.8K
Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
2.8K
01:30Heart Failure IV: Classification and Diagnostic Evaluation
313
Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...
313
01:30Heart Failure VII: Nursing Interventions
410
The first step in nursing management of a patient with heart failure involves thoroughly assessing the patient's medical history.Subjective Data: Obtain the patient's medical history of coronary artery disease, hypertension, myocardial infarction, and symptoms like dyspnea, orthopnea, and paroxysmal nocturnal dyspnea.Objective Data: Conduct a physical examination to identify findings such as jugular vein distention, pulmonary crackles, tachycardia, murmurs, peripheral edema, and vital signs,...
410
01:30Heart Failure V: Medical Management
209
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
209
01:27Heart Failure I: Introduction
676
Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...
676