Heart failure with preserved left ventricular systolic function: a hospital cohort study
Heart failure with preserved left ventricular systolic function: a hospital cohort study
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DOI：
10.1136/hrt.2004.041996
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发表时间：
2005-07-01
期刊：
影响因子：
5.7
通讯作者：
McMurray, J
中科院分区：
文献类型：
--
作者：
Berry, C;Hogg, K;McMurray, J
目的：研究左室收缩功能（LVSF）保留的心力衰竭患者与LVSF.Design降低的患者相比，队列研究，设置：城市大学医院，患者：2000年期间，528例指数急诊入院的心力衰竭患者。结果：130例（29%）患者的左室射血分数（定义为射血分数）得到保留。40%）。中位随访时间为814天（范围632 - 978天）。平均（SD）年龄为72（13）岁。女性分别占LVSF保留和降低患者的62%和45%（p = 0.001）。LVSF保留的患者（与LVSF降低的患者相比）有更高的左心室肥厚（56% vs29%）和主动脉瓣疾病（平均压差）患病率。20 mm Hg; 31%对9%）。接受血管紧张素转换酶抑制剂（65% vs 78%，p = 0.008）或螺内酯（12% vs 21%，p = 0.027）的LVSF保留患者较少。贫血倾向于在LVSF保留的患者中比在LVSF减少的患者中更常发生（女性43% vs33%，p = 0.12;男性59% vs49%，p = 0.22）。两组中显著肾功能不全的发生率相似（估计肾小球滤过率< 60 ml/min/ 1.73 m2的患者中，LVSF保留组为68%，LVSF降低组为64%，p = 0.40）。两组的死亡率相似（保留与减少51（39%）vs 132（42%），p = 0.51）。与LVSF降低的患者相比，LVSF保留的患者死亡或因心力衰竭住院的风险往往较低（56（42%）v165（53%），p = 0.072），但死亡率或因任何原因再入院率相似。然而，两组的预后相似。
Objective: To investigate how patients with heart failure with preserved left ventricular systolic function (LVSF) compare with patients with reduced LVSF.Design: Cohort study.Setting: Urban university hospital.Patients: 528 index emergency admissions with heart failure during the year 2000. Information on LVSF and follow up was available for 445 (84%) of these patients.Results: 130 (29%) patients had preserved LVSF ( defined as an ejection fraction. 40%). The median follow up was 814 days ( range 632 - 978 days). The average (SD) age was 72 ( 13) years. Women accounted for 62% and 45% of patients with preserved and reduced LVSF, respectively ( p = 0.001). Patients with preserved LVSF ( compared with those with reduced LVSF) had a higher prevalence of left ventricular hypertrophy (56% v 29%) and aortic valve disease ( mean gradient. 20 mm Hg; 31% v 9%). Fewer patients with preserved LVSF received an angiotensin converting enzyme inhibitor (65% v 78%, p = 0.008) or spironolactone (12% v 21%, p = 0.027). Anaemia tended to occur more often in patients with preserved LVSF than in those with reduced LVSF (43% v 33% for women, p = 0.12; 59% v 49% for men, p = 0.22). There was a similarly high prevalence of significant renal dysfunction in both groups ( estimated glomerular filtration rate < 60 ml/min/ 1.73 m(2) in 68% with preserved and 64% with reduced LVSF, p = 0.40). Mortality was similar in both groups ( preserved versus reduced 51 (39%) v 132 (42%), p = 0.51). Compared with patients with reduced LVSF, patients with preserved LVSF tended to have a lower risk of death or hospital admission for heart failure ( 56 ( 42%) v 165 (53%), p = 0.072) but a similar rate of death or readmission for any reason.Conclusion: Patients with preserved LVSF had more co-morbid problems than those with reduced LVSF; however, prognosis was similar for both groups.