Echocardiographic predictors of clinical outcome in patients with Left Ventricular Dysfunction enrolled in the SOLVD Registry and Trials:: Significance of left ventricular hypertrophy
Echocardiographic predictors of clinical outcome in patients with Left Ventricular Dysfunction enrolled in the SOLVD Registry and Trials:: Significance of left ventricular hypertrophy
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DOI：
10.1016/s0735-1097(00)00511-8
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发表时间：
2000-04-01
影响因子：
24
通讯作者：
Weiner, DH
中科院分区：
文献类型：
--
作者：
Quiñones, MA;Greenberg, BH;Weiner, DH
为了评估左心室（LV）和左心房（LA）尺寸的关系，射血分数（EF）和LV质量与入组左心室功能障碍研究（SOLVD）的LV功能障碍患者的后续临床结局登记和试验：背景资料缺乏关于左室质量与左室功能障碍患者预后的关系，以及左室质量与其他左室测量结果的相互作用。方法SOLVD试验（n = 577）和登记（n = 595）中登记的1，172名患者的队列具有基线超声心动图测量和随访1年。EF的1-SD差异与死亡（风险比，1.62; p = 0.0008）和心血管（CV）住院（风险比，1.59; p = 0.0001）风险增加呈负相关。因此，除了年龄、NYHA心功能分级、试验与登记研究和缺血性病因外，还对其他超声心动图参数进行了EF调整。LV质量的1-SD差异与死亡（风险比为1.3，p = 0.012）和CV住院（风险比为1.17，p = 0.018）风险增加相关。LA维度也观察到类似的结果（死亡风险比，1.32; p < 0.02; CV住院风险比，1.18; p < 0.04）。同样，LV质量大于或等于298 g和LA尺寸大于或等于4.17 cm与死亡和CV住院风险增加相关。收缩末期内径>5-0 cm仅与死亡率增加相关。在左室质量大于或等于298 g的患者中观察到EF的保护作用（EF >35%组的死亡率较低），但在左室质量35%组中没有保护作用（EF >35%组的死亡率较低），但在左室质量35%组中没有保护作用（EF> 35%组的死亡率较低）。
OBJECTIVES To assess the relation of left ventricular (LV) and left atrial (LA) dimensions, ejection fraction (EF) and LV mass to subsequent clinical outcome of patients with LV dysfunction enrolled in the Studies of Left Ventricular Dysfunction (SOLVD) Registry and Trials.BACKGROUND Data are lacking on the relation of LV mass to prognosis in patients with LV dysfunction and on the interaction of LV mass with other measurements of LV size and function as they relate to clinical outcome.METHODS A cohort of 1,172 patients enrolled in the SOLVD Trials (n = 577) and Registry (n = 595) had baseline echocardiographic measurements and follow-up for 1 year.RESULTS After adjusting for age, New York Heart Association (NYHA) functional class, Trial vs. Registry and ischemic etiology, a 1-SD difference in EF was inversely associated with an increased risk of death (risk ratio, 1.62; p = 0.0008) and cardiovascular (CV) hospitalization (risk ratio, 1.59; p = 0.0001). Consequently, the other echo parameters were adjusted for EF in addition to age, NYHA functional class, Trial vs. Registry and ischemic etiology. A 1-SD difference in LV mass was associated with increased risk of death (risk ratio of 1.3, p = 0.012) and CV hospitalization (risk ratio of 1.17, p = 0.018). Similar results were observed with the LA dimension (mortality risk ratio, 1.32; p < 0.02; CV hospitalizations risk ratio, 1.18; p < 0.04). Likewise, LV mass greater than or equal to 298 g and LA dimension greater than or equal to 4.17 cm were associated with increased risk of death and CV hospitalization. An end-systolic dimension >5-0 cm was associated with increased mortality only. A protective effect of EF was noted in patients with LV mass greater than or equal to 298 g (those in the group with EF >35% had lower mortality) but not in the group with LV mass 35% fared better) but not in the group with LV mass