Hypocalcaemia predicts 12-month re-hospitalization in heart failure
Hypocalcaemia predicts 12-month re-hospitalization in heart failure
复制标题
DOI：
10.1111/eci.13261
复制
发表时间：
2020-05-21
影响因子：
5.5
通讯作者：
Lu, Xueli
中科院分区：
文献类型：
--
作者：
Liu, Feng;Zhang, Han;Lu, Xueli
背景射血分数保留的心力衰竭(HFpEF)的潜在病理生理学尚未被充分研究。这项研究的目的是揭示基线血钙浓度与该病12个月临床结果的关系。材料与方法共350例新诊断的HFpEF患者被纳入这项前瞻性观察研究。患者中没有恶性肿瘤、肾脏疾病、甲状腺疾病、钙和维生素D补充剂。所有患者均接受了12个月的随访，终点为心脏再住院和死亡。用AIA2000ST酶免疫分析仪测定基础血钙浓度。结果多因素Cox回归分析显示，基线低血钙症与心脏再住院和死亡的风险增加相关(HR：2.10，95%CI：1.69~2.61；HR：8.26，95%CI：2.88~23.70)。此外，基线低血钙症与随访期间6分钟步行距离、生活质量评分(EQ-5D)、右股四头肌力量、左房容量指数和左心室射血分数的恶化有关(HR：1.65，95%CI：1.21~2.26；HR：1.55，95%CI：1.12~2.11；HR：2.56，95%CI：1.68~3.89；HR：1.44，95%CI：1.03~1.98；HR：1.44，95%CI：1.03~1.98；HR：1.36，95%CI：1.02~1.80)。结论基线低钙血症可部分通过左心室和骨骼肌功能通路预测不补充钙和维生素D的HFpEF患者12个月的心脏再住院和死亡。
Background Potential pathophysiology of heart failure with preserved ejection fraction (HFpEF) has not been fully explored. The aim of the study was to reveal the association of serum calcium concentration at baseline with 12-month clinical outcome in the disease.Materials and methods A total of 350 patients with newly diagnosed HFpEF were included in this prospective observational study. There were no malignant tumour, kidney disease, thyroid disease, calcium and vitamin D supplements in the patients. All of them received 12-month follow-up, and endpoints were cardiac re-hospitalization and death. Baseline serum calcium concentration was measured using AIA2000ST enzyme immunoassay analyser. Cardiopulmonary exercise, six-minute walk distance test, EQ5D questionnaire and cardiac ultrasound were performed to evaluate exercise capacity, quality of life and left ventricle function.Results Multivariate COX regression analysis revealed that baseline hypocalcaemia was associated with the increased risk of cardiac re-hospitalization and death during the follow-up period (HR: 2.10, 95% CI: 1.69-2.61; HR: 8.26, 95% CI: 2.88-23.70). Furthermore, baseline hypocalcaemia was related to the deterioration of 6-minute walk distance, quality of life score (EQ-5D), right quadriceps strength, left atrium volume index and left ventricular ejection fraction during the follow-up period (HR: 1.65, 95% CI: 1.21-2.26; HR: 1.55, 95% CI: 1.12-2.11; HR: 2.56, 95% CI: 1.68-3.89; HR: 1.44, 95% CI: 1.03-1.98; HR: 1.36, 95% CI: 1.02-1.80).Conclusion Baseline hypocalcaemia predicted 12-month cardiac re-hospitalization and death in HFpEF patients without calcium and vitamin D supplements partly through left ventricle and skeletal muscle function pathways.