Cardiology Division, Yonsei Cardiovascular Hospital and Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea.
Yonsei Med J. 2011 Jan;52(1):33-8. doi: 10.3349/ymj.2011.52.1.33.
Elderly patients (pts) (EPs; ≥ 65 years old) with newly diagnosed-acute decompensated heart failure (ND-ADHF) have not yet been studied. The aim of the present study was to investigate clinical characteristics, including echocardiographic findings and prognosis, for EPs with ND-ADHF and to compare those with non-elderly pts (NEPs).
We retrospectively investigated 256 pts (144 males, 63.0 ± 14.8 years old) who were admitted to our hospital between January 2005 and March 2009 with ND-ADHF. Clinical characteristics and echocardiographic parameters were analyzed in EPs (n = 135, 58 males) and NEPs (n = 121, 86 males).
In intergroup comparison, female gender, diabetes mellitus, previous stroke and hypertension were more common in EPs. Body mass index (22.3 ± 4.5 vs. 24.0 ± 4.4 kg/m(2)), estimated glomerular filtration rate (54.8 ± 24.3 vs. 69.2 ± 30.7 mL/min/m(2)), C-reactive protein (28.5 ± 46.9 vs. 7.6 ± 11.6 mg/dL), hemoglobin (12.3 ± 2.1 vs. 13.6 ± 2.3 g/dL) and N-terminal pro-brain natriuretic peptide level (10,538.2 ± 10,942.3 vs. 6,771.0 ± 8,964.7 pg/mL) were significantly different (p < 0.05 for all). Early mitral inflow velocity to early diastolic mitral annular velocity (E/E') was significantly higher in EPs than in NEPs (21.2 ± 9.4 vs. 18.0 ± 8.9, p < 0.05). During follow-up (44.7 ± 14.5 months), there were no significant differences in in-hospital mortality, re-hospitalization and cardiovascular mortality between EPs and NEPs (p = NS for all).
EPs with ND-ADHF have different clinical characteristics and higher LV filling pressure when compared with NEPs. However, the clinical outcomes for NEPs with ND-ADHF are not necessarily more favorable than those for EPs.
患有新发失代偿性心力衰竭（ND-ADHF）的老年患者（EPs；≥65 岁）尚未进行研究。本研究的目的是研究 EPs 与非老年患者（NEPs）的临床特征，包括超声心动图表现和预后。
我们回顾性调查了 2005 年 1 月至 2009 年 3 月期间因 ND-ADHF 住院的 256 名患者（144 名男性，63.0±14.8 岁）。分析 EPs（n=135，58 名男性）和 NEPs（n=121，86 名男性）的临床特征和超声心动图参数。
在组间比较中，EPs 中女性、糖尿病、既往卒中和高血压更为常见。体重指数（22.3±4.5 vs. 24.0±4.4 kg/m2）、估算肾小球滤过率（54.8±24.3 vs. 69.2±30.7 mL/min/m2）、C 反应蛋白（28.5±46.9 vs. 7.6±11.6 mg/dL）、血红蛋白（12.3±2.1 vs. 13.6±2.3 g/dL）和 N 末端脑利钠肽前体水平（10,538.2±10,942.3 vs. 6,771.0±8,964.7 pg/mL）差异均有统计学意义（p<0.05）。EPs 的早期二尖瓣流入速度与早期舒张期二尖瓣环速度（E/E'）明显高于 NEPs（21.2±9.4 vs. 18.0±8.9，p<0.05）。在随访（44.7±14.5 个月）期间，EPs 和 NEPs 的住院死亡率、再住院率和心血管死亡率无显著差异（p=NS）。
与 NEPs 相比，患有 ND-ADHF 的 EPs 具有不同的临床特征和更高的左心室充盈压。然而，NEPs 新发失代偿性心力衰竭的临床结局不一定优于 EPs。
