Hospitalization for heart failure in the presence of a normal left ventricular ejection fraction - Results of the new York Heart Failure Registry
Hospitalization for heart failure in the presence of a normal left ventricular ejection fraction - Results of the new York Heart Failure Registry
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DOI：
10.1016/j.jacc.2003.11.040
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发表时间：
2004-04-21
影响因子：
24
通讯作者：
Le Jemtel, TH
中科院分区：
文献类型：
--
作者：
Klapholz, M;Maurer, M;Le Jemtel, TH
目的 我们在一个大都市区进行了前瞻性多中心登记，以确定因射血分数正常的心力衰竭 (HFNEF) 住院患者的临床特征、住院病程、治疗和导致失代偿的因素。 背景 通过医院记录和国家数据库的回顾性分析，对因 HFNEF 住院的患者的临床概况进行了表征，很少有前瞻性单中心研究。 因心力衰竭 (HF) 在纽约大都市区 24 个医疗中心住院并在入院 7 天内发现左心室 (LV) 射血分数大于或等于 50% 的患者纳入本登记。收集患者人口统计数据、心力衰竭体征和症状、共存和恶化的心血管和医疗状况、治疗、实验室检查、手术和医院结果数据。按性别和种族进行分析是预先指定的。 结果 在 619 名患者中，73% 是女性，她们平均比男性大 4 岁（72.8 +/- 14.1 岁 vs. 68.6 +/- 13.8 岁，p < 0.001）。非西班牙裔黑人患者占研究人群的 30%。他们比其他患者年轻 8 岁（66.0 +/- 14.2 岁 vs. 74 +/- 13.5 岁，p < 0.001）。合并症及其患病率是：高血压，78%；左心室质量增加 82%；糖尿病，46%；和肥胖，46%。在导致住院的临床失代偿之前，86% 的患者患有符合纽约心脏协会功能分级 II 至 IV 的慢性症状。 53% 的患者发现了导致临床失代偿的因素。院内死亡率为 4.2%。 结论 因 HFNEF 住院的患者通常是有高血压病史和左心室质量增加的长期丧失行为能力的老年女性。只有一半的患者发现了临床失代偿的原因。 (C) 2004 年，美国心脏病学会基金会
OBJECTIVES We conducted a prospective multicenter registry in a large metropolitan area to define the clinical characteristics, hospital course, treatment, and factors precipitating decompensation in patients hospitalized for heart failure with a normal ejection fraction (HFNEF).BACKGROUND The clinical profile of patients hospitalized for HFNEF has been characterized by retrospective analyses of hospital records and state data banks, with few prospective single-center studies.METHODS Patients hospitalized for heart failure (HF) at 24 medical centers in the New York metropolitan area and found to have a left ventricular (LV) ejection fraction of greater than or equal to50% within seven days of admission were included in this registry. Patient demographics, signs and symptoms of HF, coexisting and exacerbating cardiovascular and medical conditions, treatment, laboratory tests, procedures, and hospital outcomes data were collected. Analysis by gender and race was prespecified.RESULTS Of 619 patients, 73% were women, who were on average four years older than men (72.8 +/- 14.1 years vs. 68.6 +/- 13.8 years, p < 0.001). Black non-Hispanic patients comprised 30% of the study population. They were eight years younger than other patients (66.0 +/- 14.2 years vs. 74 +/- 13.5 years p < 0.001). Co-morbid conditions and their prevalence were: hypertension, 78%; increased LV mass, 82%; diabetes, 46%; and obesity, 46%. Before clinical decompensation that precipitated hospitalization, 86% of patients had chronic symptoms compatible with New York Heart Association functional classes II to IV. Factors precipitating clinical decompensation were identified in 53% of patients. In-hospital mortality was 4.2%.CONCLUSIONS Patients hospitalized for HFNEF are most often chronically incapacitated elderly women with a history of hypertension and increased LV mass. Reasons for clinical decompensation are identified in only one-half of patients. (C) 2004 by the American College of Cardiology Foundation