Prognostic significance of diastolic blood pressure in patients with heart failure with preserved ejection fraction.
Prognostic significance of diastolic blood pressure in patients with heart failure with preserved ejection fraction.
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舒张压在心力衰竭患者中的预后意义，并保留的射血分数。
DOI：
10.1007/s00380-021-01788-0
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发表时间：
2021-08
影响因子：
1.5
通讯作者：
Kuwahara K
中科院分区：
文献类型：
--
作者：
Fuchida A;Suzuki S;Motoki H;Kanzaki Y;Maruyama T;Hashizume N;Kozuka A;Yahikozawa K;Kuwahara K
尽管在治疗急性心力衰竭（HF）时通常考虑收缩压（SBP），但在这种情况下很少评估舒张压（DBP）。在日本，目前还没有关于舒张压对保留射血分数（HFpEF）的老年心衰患者的预测价值的研究。本研究旨在探讨舒张压在急性失代偿性HFpEF患者中的预后意义。我们分析了2016年7月至2018年12月在Shinonoi总医院接受HF治疗的所有HFpEF患者的数据。我们排除了急性冠状动脉综合征和严重瓣膜疾病的患者。根据患者的中位舒张压分为两组；低DBP组（DBP≤77 mmHg, n = 106）和高DBP组（DBP≤77 mmHg, n = 100）。主要结局是心衰再入院。在206例入组患者（中位年龄86岁）中位随访时间为302天，其中48例患者出现主要结局。低DBP组HF再入院发生率明显高于对照组（33.0% vs 18.5%, p = 0.024）。Kaplan-Meier分析中，低DBP预测HF再入院（Log-rank检验，p = 0.013）。在Cox比例风险分析中，在调整年龄、性别、收缩压、血红蛋白、血清白蛋白、血清肌酐、b型利钠肽、肾素-血管紧张素系统抑制剂、钙通道阻滞剂、左室射血分数、冠状动脉疾病以及是否独居后，低舒张压是HF再入院的独立预测因子（风险比2.229；95%可信区间1.021-4.867;p = 0.044）。低舒张压预测HFpEF患者HF再入院。
Although systolic blood pressure (SBP) is routinely considered when treating acute heart failure (HF), diastolic blood pressure (DBP) is hardly been assessed in the situation. There are no previous studies regarding the predictive value of DBP in elderly patients with HF with preserved ejection fraction (HFpEF) in Japan. This study aimed to investigate the prognostic significance of DBP in patients with acute decompensated HFpEF. We analyzed data of all HFpEF patients admitted to Shinonoi General Hospital for HF treatment between July 2016 and December 2018. We excluded patients with acute coronary syndrome and severe valvular disease. Patients were divided into two groups according to their median DBP; the low DBP group (DBP ≤ 77 mmHg, n = 106) and the high DBP group (DBP > 77 mmHg, n = 100). The primary outcome was HF readmission. In 206 enrolled patients (median 86 years), during a median follow-up of 302 days, the primary outcome occurred in 48 patients. The incidence of HF readmission was significantly higher in the low DBP group (33.0% vs 18.5%, p = 0.024). In Kaplan–Meier analysis, low DBP predicted HF readmission (Log-rank test, p = 0.013). In Cox proportional hazard analysis, low DBP was an independent predictor of HF readmission after adjustment for age, sex, SBP, hemoglobin, serum albumin, serum creatinine, B-type natriuretic peptide, renin-angiotensin system inhibitors, calcium channel blockers, left ventricular ejection fraction, coronary artery disease, and whether they live alone (hazard ratio, 2.229; 95% confidence interval, 1.021–4.867; p = 0.044). Low DBP predicted HF readmission in patients with HFpEF.
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影响因子：
5.4
作者：
Sandesara PB;O'Neal WT;Kelli HM;Topel M;Samman-Tahhan A;Sperling LS
通讯作者：
Sperling LS
影响因子：
24
作者：
Chirinos, Julio A.;Kips, Jan G.;Jacobs, David R., Jr.;Brumback, Lyndia;Duprez, Daniel A.;Kronmal, Richard;Bluemke, David A.;Townsend, Raymond R.;Vermeersch, Sebastian;Segers, Patrick
通讯作者：
Segers, Patrick
慢性（MAGGIC）心力衰竭风险评分的荟萃分析全球组：验证一种简单的工具，用于预测心力衰竭的发病率和死亡率，并保留了射血分数。
影响因子：
5.4
作者：
Rich JD;Burns J;Freed BH;Maurer MS;Burkhoff D;Shah SJ
通讯作者：
Shah SJ
影响因子：
6.2
作者：
Lang, Roberto M.;Badano, Luigi P.;Voigt, Jens-Uwe
通讯作者：
Voigt, Jens-Uwe
影响因子：
158.5
作者：
Flint, Alexander C.;Conell, Carol;Bhatt, Deepak L.
通讯作者：
Bhatt, Deepak L.