肾功能对扩张型心肌病患者的心血管死亡率有影响。

Renal function has an effect on cardiovascular mortality in patients with dilated cardiomyopathy.

机构信息

Bezmialem Vakif University, Faculty of Medicine, Department of Cardiology, İstanbul, Turkey.

出版信息

J Cardiovasc Med (Hagerstown). 2012 Sep;13(9):554-8. doi: 10.2459/JCM.0b013e328356a2fd.

DOI:10.2459/JCM.0b013e328356a2fd

PMID:22801072

Abstract

BACKGROUND

Chronic heart failure (CHF) is a major and growing public health problem resulting from the cardiac damage caused by a variety of disease processes. CHF has many comorbid conditions such as hypertension, coronary artery disease, peripheral artery disease and chronic kidney disease (CKD). Some of the chronic conditions may have an effect on cardiac mortality in CHF patients. We have investigated the effect of renal dysfunction on cardiovascular mortality in patients with ischemic dilated cardiomyopathy (DCM) and nonischemic DCM.

METHODS

Six hundred and thirty-seven patients with DCM were evaluated between January 2003 and January 2011. All individuals in the study population were admitted to the cardiology clinic because of decompensated heart failure. In this prospective observational study, a total of 637 patients [409 men, 228 women, 18-94 years old, mean age 63 ± 13 years; New York Heart Association (NYHA) functional class II-IV] with diagnoses of ischemic (402) and nonischemic (235) DCM were enrolled in the study. Baseline glomerular filtration rate was calculated using the Cockcroft-Gault equation.

RESULTS

By the end of the study, 228 patients had died due to cardiovascular reasons. Both DCM types had similar cardiovascular mortality [151 patients with ischemic DCM (37%) vs. 77 patients with nonischemic DCM (32%); P = NS]. Renal dysfunction had an effect on cardiovascular mortality in patients with ischemic and nonischemic DCM (respectively, glomerular filtration rate 54 ± 24, 56 ± 24; P < 0.001).

CONCLUSION

We have demonstrated that renal function is a prognostic risk marker in patients with ischemic and nonischemic DCM.

摘要

背景

慢性心力衰竭（CHF）是一种主要且不断增长的公共卫生问题，由各种疾病过程导致的心脏损伤引起。CHF 有许多合并症，如高血压、冠状动脉疾病、外周动脉疾病和慢性肾脏病（CKD）。一些慢性疾病可能会对 CHF 患者的心脏死亡率产生影响。我们研究了肾功能不全对缺血性扩张型心肌病（DCM）和非缺血性 DCM 患者心血管死亡率的影响。

方法

我们评估了 2003 年 1 月至 2011 年 1 月期间的 637 例 DCM 患者。研究人群中的所有个体均因心力衰竭失代偿而被收入心内科病房。在这项前瞻性观察性研究中，共纳入 637 例患者[409 名男性，228 名女性，年龄 18-94 岁，平均年龄 63±13 岁；纽约心脏协会（NYHA）心功能分级 II-IV 级]，诊断为缺血性（402 例）和非缺血性（235 例）DCM。使用 Cockcroft-Gault 方程计算肾小球滤过率。

结果

研究结束时，共有 228 例患者因心血管原因死亡。两种类型的 DCM 患者的心血管死亡率相似[151 例缺血性 DCM（37%）与 77 例非缺血性 DCM（32%）；P=NS]。肾功能不全对缺血性和非缺血性 DCM 患者的心血管死亡率有影响（肾小球滤过率分别为 54±24、56±24；P<0.001）。