Modes of death in patients with heart failure and preserved ejection fraction
Modes of death in patients with heart failure and preserved ejection fraction
复制标题
DOI：
10.1016/j.ijcard.2016.11.154
复制
发表时间：
2017-02-01
影响因子：
3.5
通讯作者：
Bonderman, Diana
中科院分区：
文献类型：
--
作者：
Aschauer, Stefan;Zotter-Tufaro, Caroline;Bonderman, Diana
背景资料：最近的研究表明，右心室功能降低是心力衰竭和射血分数保留（HFpEF）患者结局的重要预测因素。由于受影响的患者患有广泛的非心脏并发症，目前尚不清楚，他们是否真的死于右心衰竭（RHF）或作为其他conditions.Methods的后果：在这个前瞻性登记研究中，被确诊为HFpEF的concentive患者。当地和外部医疗记录以及与亲属的电话访谈被用来确定死亡方式。如果符合以下标准，则RHF被接受为死亡模式：1.经胸超声心动图评估右心室功能不全; 2.结果：在230例完整随访的患者中，16.5%（n = 38）在平均30 +/-17个月后死亡。60.5%的死亡被归类为心血管疾病，34.2%为非心血管疾病。5.3%的患者死亡原因不明。在心血管病例（n = 23）中，91.4%的死亡归因于RHF，4.3%死于卒中，4.3%死于心源性猝死。在非心血管死亡（n = 13）中，46.2%的死亡归因于重大感染，38.4%的死亡与癌症相关。其他死亡原因包括肠梗阻（7.7%）和大出血（7.7%）。结论：在我们的HFpEF队列中，超过一半的死亡可直接归因于RHF。在一部分患者中，右心室似乎是一个有意义的治疗靶点。(C)2016爱思唯尔爱尔兰有限公司版权所有。
Background: Recent studies suggest that reduced right ventricular function is an important predictor of outcome in patients with heart failure and preserved ejection fraction (HFpEF). Because affected patients suffer from a broad spectrumof non-cardiac co-morbidities, it remains unclear, whether they actually die from right heart failure (RHF) or as a consequence of other conditions.Methods: Consecutive patients with a confirmed diagnosis of HFpEF were enrolled in this prospective registry. Local and external medical records, as well as telephone interviews with relatives were used to ascertain modes of death. RHF was accepted as a mode of death, if the following criteria were met: 1. right ventricular dysfunction assessed by transthoracic echocardiography, and 2. clinical signs of right heart decompensation at the time of death.Results: Out of 230 patients with complete follow-up, 16.5% (n = 38) died after a mean of 30 +/- 17months. 60.5% deaths were classified as cardiovascular and 34.2% as non-cardiovascular. In 5.3% patients, the reason for death remained unknown. Of the cardiovascular cases (n = 23), 91.4% of deaths were attributed to RHF, 4.3% died from stroke and 4.3% from sudden cardiac death. Of the non-cardiovascular deaths (n = 13), 46.2% of deaths were attributed to major infections and 38.4% deaths were related to cancer. Other reasons for death included ileus (7.7%) and major bleeding (7.7%).Conclusion: In our well-characterised HFpEF cohort, more than half of all deaths could directly be attributed to RHF. The right ventricle seems to be a meaningful therapeutic target in a subset of patients. (C) 2016 Elsevier Ireland Ltd. All rights reserved.