新诊断的心力衰竭中2组肺高血压的风险:基于EHR的队列分析
medRxiv : the preprint server for health sciences
|January 23, 2026
概括
保持喷射分数 (HFpEF) 的心力衰竭增加了肺高血压 (PH) 的风险,特别是在女性中. 在HF患者,特别是HFpEF的女性中,早期查PH对于及时干预至关重要.
科学领域:
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
- 流行病学 流行病学
背景情况:
- 第二组肺高血压 (PH) 显著影响心力衰竭 (HF) 的结果.
- 有限的流行病学数据存在于不同HF亚型的PH发病率:具有保留喷射分数 (HFpEF) 的HF与具有减少喷射分数 (HFrEF) 的HF.
研究的目的:
- 调查HFpEF和HFrEF之间的明显关联以及事件组2PH的发展.
- 分析与HF亚型相关的PH发病率的性别特异性差异.
主要方法:
- 分析了来自匹兹堡大学医学中心 (2015-2021) 的17,212名新诊断的HF患者的队列.
- 使用尼尔森-阿伦方法估计了PH的累积发病率.
- 考克斯的比例危险模型评估了与临床风险因素的关联,对男性和女性进行了单独的分析.
主要成果:
- 在4.5年的时间里,发现了1636例PH病例. 最初在HFrEF中较高,PH发病率在2年后被HFpEF所超越.
- 总的累计发病率为HFpEF的33.51%和HFrEF的30.87%. 女性的PH发病率 (36.25%) 比男性 (29.69%) 高.
- 与HFrEF相比,女性的HFpEF与发生PH的风险增加了23% (HR:1.23),男性没有观察到这种差异.
结论:
- 与HFrEF相比,HFpEF具有更高的PH发展风险,特别是在女性中.
- 这些发现强调了在了解PH发育途径时考虑HF亚型和性别的重要性.
- 结果主张在所有HF患者中加强PH查和风险分层,特别是患有HFpEF的女性,以便更早地进行干预并改善临床结果.
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