Noninvasive Assessment of Preload Reserve Enhances Risk Stratification of Patients With Heart Failure With Reduced Ejection Fraction
Noninvasive Assessment of Preload Reserve Enhances Risk Stratification of Patients With Heart Failure With Reduced Ejection Fraction
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DOI：
10.1161/circimaging.117.007160
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发表时间：
2018-05-01
影响因子：
7.5
通讯作者：
Hirata, Ken-Ichi
中科院分区：
文献类型：
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作者：
Matsumoto, Kensuke;Onishi, Akira;Hirata, Ken-Ichi
背景：腿部正压动作可以安全、无创地施加预负荷而不增加总体液量。本研究的目的是确定前负荷压力是否可用于射血分数降低的心力衰竭患者的危险分层。方法和结果：本研究前瞻性招募了120例射血分数降低的心力衰竭患者。每搏作功指数由每搏输出量指数和平均血压的乘积来估计，E/e比值用于估计心室充盈压。超声心动图参数均在休息和腿部正压应力。在20个月的中位随访期内，30例患者发生了不良心血管事件。在预负荷期间，每搏作功指数显著增加（从3280 ± 1371增加到3857 ± 1581 mmHg mL/m2; P
Background: The leg-positive pressure maneuver can safely and noninvasively apply preload stress without increase in total body fluid volume. The purpose of this study was to determine whether preload stress could be useful for risk stratification of patients with heart failure with reduced ejection fraction.Methods and Results: For this study, 120 consecutive patients with heart failure with reduced ejection fraction were prospectively recruited. The stroke work index was estimated as product of stroke volume index and mean blood pressure, and the E/e ratio was calculated to estimate ventricular filling pressure. The echocardiographic parameters were obtained both at rest and during leg-positive pressure stress. During the median follow-up period of 20 months, 30 patients developed adverse cardiovascular events. During preload stress, stroke work index increased significantly (from 32801371 to 3857 +/- 1581 mmHgmL/m(2); P