Değertekin Muzaffer, Erol Cetin, Ergene Oktay, Tokgözoğlu Lale, Aksoy Mehmet, Erol Mustafa Kemal, Eren Mehmet, Sahin Mahmut, Eroğlu Elif, Mutlu Bülent, Kozan Omer
Department of Cardiology, Yeditepe University Hospital, İstanbul, Turkey.
Turk Kardiyol Dern Ars. 2012 Jun;40(4):298-308. doi: 10.5543/tkda.2012.65031.
The aim of this study was to determine the prevalence of heart failure (HF) in adult residents of Turkey based on echocardiography and N-terminal B type natriuretic factor.
4650 randomly selected residents aged ≥ 35 years were enrolled. Height, weight, waist and hip circumference, and blood pressure measurements were taken, and a 12-lead ECG was performed. Advanced age, hypertension (HT), diabetes mellitus (DM), obesity, and chronic renal failure (CRF) were assessed. History of any heart disease, any abnormal ECG, or an NT-proBNP ≥ 120 pg/mL was accepted as echocardiography indication. Patients with systolic and/or diastolic dysfunction, or NT-proBNP ≥ 2000 pg/mL were classified as having HF if their functional capacity was NYHA ≥ Class II, and were classified as having asymptomatic left ventricular dysfunction (ASVD) if their functional capacity was NYHA <Class I.
The absolute and estimated prevalences were 2.9% and 6.9% for HF, and 4.8% and 7.9% for ASVD, respectively. Advanced age, male gender, history of heart disease, HT and CRF were independent predictors of HF. In patients with ejection fraction (EF) <50%, HF prevalence was higher in men, while HF prevalences were higher in women when EF ≥ 50%. In global sum, HF and ALVD prevalence were similar in male and females.
The prevalences of HF and ASVD are higher in Turkey when compared with western countries, despite a younger Turkish population. The established predictors of HF are valid for Turkey as well. There is a significant ASVD population in Turkey with similar characteristics and risk factors to HF. Focusing on the early detection and treatment of ASVD may prevent the progression to HF, and therefore would decrease the prevalence of HF in Turkey.
本研究旨在基于超声心动图和N端B型利钠肽因子确定土耳其成年居民心力衰竭(HF)的患病率。
纳入4650名年龄≥35岁的随机选取居民。测量身高、体重、腰围和臀围以及血压,并进行12导联心电图检查。评估高龄、高血压(HT)、糖尿病(DM)、肥胖和慢性肾衰竭(CRF)。任何心脏病史、任何异常心电图或N末端脑钠肽前体(NT-proBNP)≥120 pg/mL被视为超声心动图检查指征。收缩和/或舒张功能障碍患者,或NT-proBNP≥2000 pg/mL且功能能力为纽约心脏协会(NYHA)≥Ⅱ级的患者被归类为患有HF,功能能力为NYHA<Ⅰ级的患者被归类为患有无症状左心室功能障碍(ASVD)。
HF的绝对患病率和估计患病率分别为2.9%和6.9%,ASVD的绝对患病率和估计患病率分别为4.8%和7.9%。高龄、男性、心脏病史、HT和CRF是HF的独立预测因素。射血分数(EF)<50%的患者中,男性HF患病率较高,而EF≥50%时女性HF患病率较高。总体而言,男性和女性的HF和ASVD患病率相似。
与西方国家相比,土耳其HF和ASVD的患病率更高,尽管土耳其人口更年轻。已确定的HF预测因素在土耳其也有效。土耳其有大量ASVD人群,其特征和危险因素与HF相似。关注ASVD的早期检测和治疗可能会预防其进展为HF,从而降低土耳其HF的患病率。