Hess O M, Turina J, Goebel N H, Krayenbühl H P
Schweiz Med Wochenschr. 1976 Nov 6;106(45):1577-9.
In 30 patients with the clinical, hemodynamic and angiographic findings of congestive cardiomyopathy, physical working capacity (PWC) and left ventricular (LV) ejection phase indexes at rest (EI), assessed by LV ejection fraction, enddiastolic volume, and mean rate of circumferential fiber shortening were determined. Based on PWC and EI, the following 3 functional groups were obtained: group 1 (n = 6) with normal PWC and borderline EI (subclinical congestive cardiomyopathy), group 2 (n = 10) with normal PWC and decreased EI, and group 3 (n = 14) with reduced PWC and severely depressed EI. The clinical course was followed for 24 months. In group 1 the functional state remained unchanged in all 6 patients. In group 2, 3 patients, changed to functional group 3 and 2 died during the observation period. In group 3, 3 patients improved and changed to functional group 2, 5 remained unchanged and 6 died after an observation period of 16 months. It is concluded (1) that PWC in congestive cardiomyopathy may be preserved despite depressed LV function, and (2) that the functional classification has important prognostic implications, in view of the fact that annual mortality in group 1 was 0%, in group 2 7% and in group 3 32%.
对30例有充血性心肌病临床、血流动力学及血管造影表现的患者，测定其静息状态下的体力工作能力（PWC）及左心室（LV）射血期指标（EI），EI通过左心室射血分数、舒张末期容积及圆周纤维缩短平均速率进行评估。根据PWC和EI，得到以下3个功能组：第1组（n = 6），PWC正常，EI临界（亚临床充血性心肌病）；第2组（n = 10），PWC正常，EI降低；第3组（n = 14），PWC降低，EI严重降低。随访临床病程24个月。第1组的所有6例患者功能状态保持不变。第2组中，3例转变为功能组3，2例在观察期内死亡。第3组中，3例病情改善并转变为功能组2，5例保持不变，6例在16个月的观察期后死亡。得出结论：（1）尽管左心室功能降低，但充血性心肌病患者的PWC仍可能保持正常；（2）鉴于第1组年死亡率为0%，第2组为7%，第3组为32%，这种功能分类具有重要的预后意义。
