Pulmonary hypertension predicts all-cause mortality in patients with heart failure: a retrospective cohort study
Pulmonary hypertension predicts all-cause mortality in patients with heart failure: a retrospective cohort study
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DOI：
10.1093/eurjhf/hfr159
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发表时间：
2012-02-01
影响因子：
18.2
通讯作者：
Lang, Chim C.
中科院分区：
文献类型：
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作者：
Szwejkowski, Benjamin R.;Elder, Douglas H. J.;Lang, Chim C.
目的在左心室收缩功能不全(LVSD)中存在肺动脉高压(PH)，而症状性心力衰竭是一个不祥的征兆。关于心力衰竭患者PH严重程度增加所带来的风险，数据不足。方法和结果我们利用卫生信息中心(HIC)维护的Tayside超声心动图数据库(>；50000个超声心动图)，在苏格兰泰赛德(人口约40万)进行了一项有记录的连锁研究。HIC的数据集包括死亡率数据、心血管药物和其他通过社区健康指数(CHI)编号匿名链接的医疗活动。如果患者患有LVSD，有有效的右室收缩压(RVSP)测量，并且有环状利尿剂处方(在超声心动图前不超过一年提供)，则纳入分析。用Cox比例风险模型检验RVSP对全因死亡率的影响。共有1612名患者[平均年龄75.2+/-10.9岁(SD)；57.4%男性]符合入选标准。队列的平均右室压为44.9+/-13.1毫米汞柱，平均随访时间为2.8+/-2.5年。RVSP每递增5 mm HgRVSP，在调整包括LVSD程度和是否存在慢性阻塞性肺疾病在内的混杂因素后，全因死亡的危险比(HR)为1.06(1.03~1.08，P
Aims The presence of pulmonary hypertension (PH) in left ventricular systolic dysfunction (LVSD) and symptomatic heart failure is an ominous sign. There are insufficient data regarding the risk conferred by increasing severity of PH in patients with heart failure.Methods and results We performed a record linkage study in Tayside, Scotland (population similar to 400 000) utilizing the Tayside echocardiogram database (>50 000 echocardiograms) maintained by the Health Informatics Centre (HIC). Data sets from the HIC include mortality data, cardiovascular medications, and other healthcare activities linked anonymously by the community health index (CHI) number. Patients were included in the analysis if they had LVSD, had a valid right ventricular systolic pressure (RVSP) measurement, and had a loop diuretic prescription (provided not more than 1 year prior to echocardiogram). A Cox proportional hazard model was used to examine the effects of RVSP on all-cause mortality. A total of 1612 patients [mean age, 75.2 +/- 10.9 (SD) years; 57.4% male] met the entry criteria. Mean RVSP for the cohort was 44.9 +/- 13.1 mmHg and mean follow-up was 2.8 +/- 2.5 years. For each 5 mmHg stepwise increase in RVSP, after adjustment for confounding factors including the degree of LVSD and the presence of chronic obstructive pulmonary disease, the hazard ratio (HR) for all-cause mortality was 1.06 (1.03-1.08, P