Association of early versus delayed normalisation of left ventricular ejection fraction with mortality in ischemic cardiomyopathy.
Association of early versus delayed normalisation of left ventricular ejection fraction with mortality in ischemic cardiomyopathy.
复制标题
缺血性心肌病患者左室射血分数早期和延迟恢复正常与死亡率的关系。
DOI：
10.1136/openhrt-2020-001528
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发表时间：
2021-03
期刊：
影响因子：
2.7
通讯作者：
Adamo L
中科院分区：
文献类型：
--
作者：
Schiffer WB;Perry A;Deych E;Brown DL;Adamo L
在非缺血性心肌病和左心室射血分数(LVEF)降低的患者中，LVEF正常化与改善预后相关。然而，关于缺血性心肌病患者和恢复的左心室射血分数的数据缺乏。本研究的目的是评估缺血性心肌病患者左心室射血分数正常化的预后意义。我们对外科治疗缺血性心力衰竭(STICH)试验进行了一项非预先指定的事后分析，以确定在随访期间LVEF正常化(>；50%)与死亡率之间的关系。在参加STICH试验的1212名左心室射血分数为35%的患者中，932人在登记后4个月和/或2 年接受了左心室射血分数的评估。其中18例患者术后4个月LVEF恢复正常，35例患者术后2年恢复正常。术后4个月的LVEF恢复与2年的LVEF恢复无相关性。在未校正分析(LOG-RANK检验p=0.54)或COX比例风险分析(HR：0.93；95%CI：0.48至1.80；p=0.82)中，LVEF在4个月后恢复与全因死亡率的降低无关。两年后的射血分数恢复与全因死亡率的降低有关，这在未经调整的分析(对数等级检验p=0.004)和COX比例风险模型(HR：0.41；95%CI：0.21至0.80；p=0.009)中都是如此。在缺血性心肌病患者中，LVEF的延迟正常化与死亡率的降低有关，而LVEF的早期恢复则不相关。需要进一步的研究来证实这些发现。
In patients with non-ischaemic cardiomyopathy and reduced left ventricular ejection fraction (LVEF), normalisation of LVEF is associated with improved outcomes. However, data on patients with ischaemic cardiomyopathy and recovered LVEF are lacking. The goal of this study was to assess the prognostic significance of normalisation of the LVEF in patients with ischaemic cardiomyopathy. We performed a non-prespecified post hoc analysis of the Surgical Treatment for Ischaemic Heart Failure (STICH) trial to determine the association between normalisation of LVEF (>50%) and mortality during follow-up. Of the 1212 patients with LVEF <35% enroled in the STICH trial, 932 underwent assessment of LVEF at 4 months and/or 2 years after enrolment. Among them, 18 patients experienced normalisation in LVEF at 4-month follow-up and 35 patients experienced recovery in LVEF at 2 years. Recovery of LVEF at 4 months and recovery of LVEF at 2 years were not correlated. Recovery of LVEF at 4 months was not associated with reduced all-cause mortality in unadjusted analysis (log-rank test p=0.54) or in Cox proportional hazards analysis (HR: 0.93; 95% CI: 0.48 to 1.80; p=0.82). Ejection fraction recovery at 2 years was associated with a reduction in all-cause mortality, both in unadjusted analysis (log-rank test p=0.004) and in the Cox proportional hazard model (HR: 0.41; 95% CI: 0.21 to 0.80; p=0.009). In patients with ischaemic cardiomyopathy, delayed normalisation of LVEF is associated with reduced mortality, whereas early recovery of LVEF is not. Further studies are needed to confirm these findings.
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影响因子：
7.5
作者：
Klem, Igor;Shah, Dipan J.;Kim, Raymond J.
通讯作者：
Kim, Raymond J.
影响因子：
18.2
作者：
Lupon, Josep;Diez-Lopez, Carles;Bayes-Genis, Antoni
通讯作者：
Bayes-Genis, Antoni
缺血性心肌病患者的冠状动脉搭桥手术。
DOI：
10.1056/nejmoa1602001
发表时间：
2016-04-21
期刊：
The New England journal of medicine
影响因子：
--
作者：
Velazquez EJ;Lee KL;Jones RH;Al-Khalidi HR;Hill JA;Panza JA;Michler RE;Bonow RO;Doenst T;Petrie MC;Oh JK;She L;Moore VL;Desvigne-Nickens P;Sopko G;Rouleau JL;STICHES Investigators
通讯作者：
STICHES Investigators
DOI：
10.1056/nejmoa1100356
发表时间：
2011-04-28
期刊：
The New England journal of medicine
影响因子：
--
作者：
Velazquez EJ;Lee KL;Deja MA;Jain A;Sopko G;Marchenko A;Ali IS;Pohost G;Gradinac S;Abraham WT;Yii M;Prabhakaran D;Szwed H;Ferrazzi P;Petrie MC;O'Connor CM;Panchavinnin P;She L;Bonow RO;Rankin GR;Jones RH;Rouleau JL;STICH Investigators
通讯作者：
STICH Investigators
影响因子：
8.1
作者：
Monge Garcia, Manuel Ignacio;Jian, Zhongping;Pinsky, Michael R.
通讯作者：
Pinsky, Michael R.