Department of Medical Science and Cardiorenal Medicine, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan.
J Cardiol. 2009 Aug;54(1):101-7. doi: 10.1016/j.jjcc.2009.04.015. Epub 2009 Jun 9.
Studies of the characteristics, risk factors, prognostic factors, and outcomes of diastolic heart failure (DHF) have yielded inconsistent findings. Moreover, few epidemiological studies of DHF have been performed in Japan.
We studied patients with heart failure who were admitted consecutively to Yokohama City University Hospital from 2000 through 2003. Heart failure with a left ventricular ejection fraction (LVEF) of > or = 50% was classified as DHF (n=67), and that with an LVEF of < or = 35% was classified as systolic heart failure (SHF; n=72). Relative wall thickness (RWT) (0.61 vs. 0.34, p<0.0001) and left ventricular mass index (210.3 vs. 152.1, p<0.0001) were greater in DHF than in SHF. Age (odds ratio [OR]=1.068, 95% CI=1.020-1.119; p=0.006) and RWT (OR=17.945, CI=5.883-54.745; p<0.0001) were positive risk factors for DHF. A history of myocardial infarction was a negative risk factor for DHF (OR=0.053, CI=0.008-0.342; p=0.002). Left ventricular mass index was slightly but not significantly related to DHF (OR=1.010, CI=1.000-1.019; p=0.053). Survival did not differ significantly between patients with DHF and those with SHF. Advancing age and a greater RWT were positive risk factors for DHF.
LV geometry of DHF and SHF are quite different. DHF is characterized by concentric hypertrophy of the left ventricle, whereas SHF is characterized by eccentric hypertrophy. Age and RWT were positive risk factors for DHF. Survival is similar in DHF and SHF.
关于舒张性心力衰竭（DHF）的特征、风险因素、预后因素和结局的研究结果并不一致。此外，在日本进行的 DHF 流行病学研究很少。
我们研究了 2000 年至 2003 年连续入住横滨市立大学医院的心力衰竭患者。左心室射血分数（LVEF）≥50%的心衰被归类为 DHF（n=67），LVEF≤35%的心衰被归类为收缩性心力衰竭（SHF；n=72）。DHF 的相对壁厚度（RWT）（0.61 比 0.34，p<0.0001）和左心室质量指数（210.3 比 152.1，p<0.0001）大于 SHF。年龄（比值比[OR]=1.068，95%可信区间[CI]=1.020-1.119；p=0.006）和 RWT（OR=17.945，CI=5.883-54.745；p<0.0001）是 DHF 的阳性危险因素。心肌梗死史是 DHF 的阴性危险因素（OR=0.053，CI=0.008-0.342；p=0.002）。左心室质量指数与 DHF 有轻微但无统计学意义的关系（OR=1.010，CI=1.000-1.019；p=0.053）。DHF 患者与 SHF 患者的生存率无显著差异。年龄增长和 RWT 增加是 DHF 的阳性危险因素。
DHF 和 SHF 的左心室几何形状有很大不同。DHF 的特征是左心室向心性肥厚，而 SHF 的特征是离心性肥厚。年龄和 RWT 是 DHF 的阳性危险因素。DHF 和 SHF 的生存率相似。
