Vijayaraghavan Kris, Crum Sue, Cherukuri Sangita, Barnett-Avery Leslie
Arizona Heart Hospital, Phoenix, AZ 85016, USA.
Congest Heart Fail. 2004 Mar-Apr;10(2 Suppl 2):22-7. doi: 10.1111/j.1527-5299.2004.03408.x.
Assessment and prognosis of chronic heart failure is often difficult due to a lack of objective and easily obtainable parameters that accurately reflect disease status. This study was conducted to determine whether impedance cardiography (ICG) parameters were associated with changes in functional and quality-of-life measures in chronic heart failure patients. Retrospective chart review identified 64 patients (73% male, aged 73+/-13 years) with paired ICG measurements followed for 180+113 days. Outcome measures were changes in New York Heart Association class, 6-minute walk distance, patient visual analog scale score, and Minnesota Living with Heart Failure Questionnaire score. Measures of ICG, heart rate and blood pressure, left ventricular ejection fraction, and B-type natriuretic peptide levels were assessed for their association with outcome measures. From baseline to final evaluation, there were significant changes (p<0.05) in New York Heart Association class (from 3.2+/-0.5 to 3.0+/-0.6), 6-minute walk distance (from 668+/-380 m to 874+/-390 m), patient visual analog scale score (from 49+/-10 to 64+/-20), Minnesota Living with Heart Failure Questionnaire score (from 54+/-22 to 39+/-22), and ICG parameters of stroke index (from 38+/-9 to 41+/-8), left ventricular ejection time (from 273+/-42 to 291+/-33), and systolic time ratio (from 0.56+/-0.2 to 0.52+/-0.2). Changes in multivariate ICG parameters were significantly correlated to changes in New York Heart Association class (R, 0.80), 6-minute walk distance (R, 0.94), patient visual analog scale score (R, 0.69), and Minnesota Living with Heart Failure Questionnaire score (R, 0.67). ICG provides objective data that reflects changes in chronic heart failure disease status and treatment effectiveness.
由于缺乏准确反映疾病状态的客观且易于获取的参数，慢性心力衰竭的评估和预后往往很困难。本研究旨在确定阻抗心动图（ICG）参数是否与慢性心力衰竭患者的功能和生活质量指标变化相关。回顾性病历审查确定了64例患者（73%为男性，年龄73±13岁），对其进行了配对ICG测量，并随访180±113天。结局指标为纽约心脏协会分级、6分钟步行距离、患者视觉模拟量表评分和明尼苏达心力衰竭生活问卷评分的变化。评估了ICG、心率和血压、左心室射血分数以及B型利钠肽水平的测量值与结局指标之间的关联。从基线到最终评估，纽约心脏协会分级（从3.2±0.5降至3.0±0.6）、6分钟步行距离（从668±380米增至874±390米）、患者视觉模拟量表评分（从49±10增至64±20）、明尼苏达心力衰竭生活问卷评分（从54±22降至39±22）以及ICG参数中的每搏输出量指数（从38±9增至41±8）、左心室射血时间（从273±42增至291±33）和收缩期时间比（从0.56±0.2降至0.52±0.2）均有显著变化（p<0.05）。多变量ICG参数的变化与纽约心脏协会分级的变化（R=0.80）、6分钟步行距离的变化（R=0.94）、患者视觉模拟量表评分的变化（R=0.69）以及明尼苏达心力衰竭生活问卷评分的变化（R=0.67）显著相关。ICG提供了反映慢性心力衰竭疾病状态和治疗效果变化的客观数据。
