Association of Body-Weight Fluctuation With Outcomes in Heart Failure With Preserved Ejection Fraction.
Association of Body-Weight Fluctuation With Outcomes in Heart Failure With Preserved Ejection Fraction.
复制标题
体重波动与射血分数保留的心力衰竭结局的关系
DOI：
10.3389/fcvm.2021.689591
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发表时间：
2021
影响因子：
3.6
通讯作者：
Huang P
中科院分区：
文献类型：
--
作者：
Li Y;Yu Y;Wu Y;Liang W;Dong B;Xue R;Dong Y;Zhu W;Huang P
目的：探讨射血分数保留性心力衰竭（HFpEF）患者体重波动与临床结局风险的关系。方法和结果：我们测量了来自美洲的1，691名HFpEF参与者的体重相对于基线和随访访视的个体差异，这些参与者来自醛固酮拮抗剂治疗保留心功能的心力衰竭（TOPCAT）试验。主要终点是任何心血管事件（心血管疾病死亡、非致死性心肌梗死、心脏骤停流产或因HF住院的复合终点）。根据平均连续变异性测量体重波动，高变异性定义为大于或等于中位数。校正危险因素、平均体重和体重变化后，体重变异性每增加1个标准差与任何心血管事件的风险增加显著相关（风险比[HR] 1.23，95%置信区间[CI] 1.15-1.33，P < 0.001）。与低变异性患者相比，高变异性患者发生任何心血管事件的风险增加47%，全因死亡的风险增加27%。这种关联在纽约心脏协会功能分级I/II与III/IV、肥胖与非肥胖、体重减轻、体重增加与稳定的患者中相似（相互作用的P值均不显著）。结论：在HFpEF患者中，体重波动与心血管事件风险增加相关，与传统心血管风险因素无关，与HF严重程度、基线体重或体重变化方向无关。临床试验注册：醛固酮拮抗剂治疗心力衰竭和收缩功能保留的成人（TOPCAT），https://clinicaltrials.gov，标识符[NCT 00094302]。
Aims: To investigate the relationship between body-weight fluctuation and risks of clinical outcomes in patients with heart failure with preserved ejection fraction (HFpEF). Methods and Results:We measured intra-individual variations in body weight from baseline and follow-up visits in 1,691 participants with HFpEF from the Americas from the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) trial. The primary endpoint was any cardiovascular events (a composite of death from cardiovascular disease, non-fatal myocardial infarction, aborted cardiac arrest, or hospitalization for HF). The body-weight fluctuation was measured according to average successive variability and high variability was defined as greater than or equal to the median. After adjustment for risk factors, mean body weight and weight change, each increase of 1 standard deviation in body-weight variability was significantly associated with increased risks of any cardiovascular events (hazard ratio [HR] 1.23, 95% confidence interval [CI] 1.15–1.33, P < 0.001). Patients with high variability had a 47% increased risk of any cardiovascular events and 27% increased risk of all-cause death compared with those with low variability. Such association was similar among patients with New York Heart Association functional class I/II vs. III/IV, obesity vs. non-obesity, and weight loss, gain vs. stability (the P-values for interaction were all insignificant). Conclusion: Among patients with HFpEF, body-weight fluctuation was associated with increased risks of cardiovascular events independent of traditional cardiovascular risk factors, and regardless of HF severity, baseline weight or weight change direction. Clinical Trial Registration: Aldosterone antagonist therapy for adults with heart failure and preserved systolic function (TOPCAT), https://clinicaltrials.gov, identifier [NCT00094302].
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影响因子：
158.5
作者：
Bangalore, Sripal;Fayyad, Rana;Waters, David D.
通讯作者：
Waters, David D.
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通讯作者：
BROWNELL, KD
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通讯作者：
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