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射血分数保留的心力衰竭的预后:一项基于人群的5年前瞻性研究。

Prognosis of heart failure with preserved ejection fraction: a 5 year prospective population-based study.

作者信息

Tribouilloy Christophe, Rusinaru Dan, Mahjoub Haïfa, Soulière Vicky, Lévy Franck, Peltier Marcel, Slama Michel, Massy Ziad

机构信息

Department of Cardiovascular Disease, INSERM, ERI 12, Amiens and University Hospital, Amiens 80054, France.

出版信息

Eur Heart J. 2008 Feb;29(3):339-47. doi: 10.1093/eurheartj/ehm554. Epub 2007 Dec 22.

Abstract

AIMS

This study was designed to identify the characteristics and long-term prognosis of heart failure with preserved ejection fraction (HFPEF) in patients hospitalized for a first episode of HF.

METHODS AND RESULTS

Consecutive patients (n = 799) hospitalized for a first episode of HF during 2000 in the Somme department (France) were recruited. EF was available in 662 (83%) patients, representing the study population. Patients with HFPEF (55.6% of cases) were significantly older, with a high proportion of women. During the 5 year follow-up, 370 patients (56%) died. Patients with HFPEF had a significantly lower 5 year survival than the age- and sex-matched general population (43 vs. 72%). Five year survival rates were not significantly different in patients with preserved and reduced EF (43 vs. 46%; P = 0.95). Both groups had similar relative 5 year survival rates compared with the general population. Multivariable analysis identified age, stroke, chronic obstructive pulmonary disease, cancer, diabetes, low glomerular filtration rate, and hyponatraemia as independent predictors of 5 year mortality in patients with HFPEF.

CONCLUSIONS

Heart failure with preserved ejection fraction has a poor prognosis, comparable with that of HF with reduced EF, with a 5 year survival rate after a first episode of 43% and a high excess mortality compared with the general population.

摘要

目的

本研究旨在确定因首次发生心力衰竭(HF)而住院的射血分数保留的心力衰竭(HFpEF)患者的特征和长期预后。

方法与结果

招募了2000年在法国索姆省因首次发生HF而住院的连续患者(n = 799)。662例(83%)患者有射血分数(EF)数据,构成研究人群。HFpEF患者(占病例的55.6%)年龄显著更大,女性比例高。在5年随访期间,370例患者(56%)死亡。HFpEF患者的5年生存率显著低于年龄和性别匹配的普通人群(43%对72%)。射血分数保留和降低的患者5年生存率无显著差异(43%对46%;P = 0.95)。与普通人群相比,两组的5年相对生存率相似。多变量分析确定年龄、中风、慢性阻塞性肺疾病、癌症、糖尿病、低肾小球滤过率和低钠血症是HFpEF患者5年死亡率的独立预测因素。

结论

射血分数保留的心力衰竭预后较差,与射血分数降低的HF相当,首次发作后的5年生存率为43%,与普通人群相比死亡率过高。

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