Ghali J K, Kadakia S, Bhatt A, Cooper R, Liao Y
Department of Medicine, Cook County Hospital, Chicago, Ill.
Am Heart J. 1992 Apr;123(4 Pt 1):993-7. doi: 10.1016/0002-8703(92)90709-5.
The impact of impaired versus preserved systolic function on survival of patients with heart failure was investigated in 78 patients with decompensated heart failure. Patients were classified on the basis of their left ventricular systolic performance, as defined by fractional shortening (FS); group I (n = 56) had impaired systolic function (FS less than 24%) and group II (n = 22) had preserved systolic function (FS greater than or equal to 24%). Mean ejection fraction was 15 +/- 5% and 40 +/- 13% for these groups, respectively. By the end of 48 months, 36 patients in group I had died compared with only 22 patients in group II (p less than 0.05). Both systolic and diastolic blood pressure were significantly lower in the deceased patients compared with the survivors in group I (p less than 0.05). There was a trend for an opposite direction in the relationship of blood pressure to mortality in group II. We conclude that the prognosis of patients with heart failure and preserved systolic function is more favorable than that of those with impaired function, and that blood pressure may have a differential prognostic meaning in the two groups.
在78例失代偿性心力衰竭患者中，研究了收缩功能受损与保留对心力衰竭患者生存的影响。根据分数缩短率（FS）定义的左心室收缩功能，将患者分类；I组（n = 56）收缩功能受损（FS小于24%），II组（n = 22）收缩功能保留（FS大于或等于24%）。这些组的平均射血分数分别为15±5%和40±13%。到48个月结束时，I组有36例患者死亡，而II组只有22例患者死亡（p<0.05）。与I组的幸存者相比，死亡患者的收缩压和舒张压均显著降低（p<0.05）。II组血压与死亡率的关系有相反方向的趋势。我们得出结论，收缩功能保留的心力衰竭患者的预后比收缩功能受损的患者更有利，并且血压在两组中可能具有不同的预后意义。
