El-Menyar Ayman, Sulaiman Kadhim, AlSadawi Ali, AlSheikh-Ali Alawi A, AlMahameed Wael, Bazargani Nooshin, AlMotarreb Ahmed, Amin Haitham, Asaad Nidal, Al Habib Khalid, Ridha Mustafa, Al-Jarallah Mohammed, Al-Thani Hassan, AlFaleh Husam, Singh Rajvir, Panduranga Prashanth, Al Suwaidi Jassim
1 Clinical Medicine, Weill Cornel Medical College, Doha, Qatar.
2 Clinical Research, Hamad General Hospital, Doha, Qatar.
Angiology. 2017 Mar;68(3):196-206. doi: 10.1177/0003319716647320. Epub 2016 Sep 29.
We assessed the frequency and implications of a history of syncope of up to 1 year prior to hospitalization with acute heart failure (AHF) between February and November 2012. Data were collected for 5005 patients hospitalized with AHF and analyzed and compared according to the absence/presence of a history of syncope (group 1 vs group 2). Prior syncope among patients with heart failure was 5.3%. Age, gender, hypertension, atrial fibrillation, bundle branch block, left ventricular ejection fraction (LVEF), and obstructed coronary vessels were comparable in the 2 groups. Group 2 patients were more likely to smoke or have diabetes mellitus, stroke, and cardiac arrest. Group 2 patients frequently required aggressive treatment and had more worse in-hospital and 1-year outcomes compared to group 1. After adjustment for age, sex, ethnicity, and LVEF, multivariate regression analysis showed that history of syncope predicted in-hospital mortality (odds ratio: 2.61; 95% confidence interval: 1.707-4.002). History of syncope during the year prior to the index admission with AHF is a marker of worse outcomes regardless of patient age and LVEF. Further studies are required to confirm this observation and its clinical implications.
我们评估了2012年2月至11月期间因急性心力衰竭（AHF）住院前长达1年的晕厥病史的发生频率及其影响。收集了5005例因AHF住院患者的数据，并根据有无晕厥病史进行分析和比较（第1组与第2组）。心力衰竭患者中既往晕厥发生率为5.3%。两组在年龄、性别、高血压、心房颤动、束支传导阻滞、左心室射血分数（LVEF）和冠状动脉阻塞情况方面具有可比性。第2组患者更有可能吸烟或患有糖尿病、中风和心脏骤停。与第1组相比，第2组患者经常需要积极治疗，且住院期间和1年结局更差。在对年龄、性别、种族和LVEF进行调整后，多因素回归分析显示晕厥病史可预测住院死亡率（比值比：2.61；95%置信区间：1.707 - 4.002）。无论患者年龄和LVEF如何，在因AHF首次入院前一年的晕厥病史都是预后较差的一个标志。需要进一步研究来证实这一观察结果及其临床意义。
