上升型模式是射血分数保留的心力衰竭患者不良事件的一种新型预测指标。
Riser Pattern Is a Novel Predictor of Adverse Events in Heart Failure Patients With Preserved Ejection Fraction.
作者信息
Komori Takahiro, Eguchi Kazuo, Saito Toshinobu, Hoshide Satoshi, Kario Kazuomi
机构信息
Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine.
出版信息
Circ J. 2017 Jan 25;81(2):220-226. doi: 10.1253/circj.CJ-16-0740. Epub 2016 Dec 23.
BACKGROUND
The cardiovascular prognosis of heart failure with preserved ejection fraction (HFpEF) has been shown to be similar to that of heart failure with reduced ejection fraction (HFrEF). It is unknown which factors predict cardiovascular outcome in HFpEF. We tested the hypothesis that the abnormal pattern of circadian blood pressure (BP) rhythm known as the riser BP pattern is associated with adverse outcomes in HFpEF.
METHODS AND RESULTS
We performed a prospective, observational cohort study of hospitalized HF patients who underwent ambulatory BP monitoring (ABPM). Five hundred and sixteen hospitalized HF patients (age, 69±13 years; male, n=321 [62%]; female, n=195 [38%]) were followed up for a median 20.9 months. The composite outcome consisting of all-cause mortality and cardiovascular events was observed in 220 patients. On Kaplan-Meier analysis, the riser BP pattern subgroup had a significantly higher incidence of the composite outcome than the other subgroups of HFpEF patients (HR, 3.01; 95% CI: 1.54-6.08, P<0.01), but not the HFrEF patients.
CONCLUSIONS
The riser BP pattern was found to be a novel predictor of cardiovascular outcome in HFpEF patients.
背景
射血分数保留的心力衰竭（HFpEF）的心血管预后已被证明与射血分数降低的心力衰竭（HFrEF）相似。目前尚不清楚哪些因素可预测HFpEF的心血管结局。我们检验了这样一个假设，即被称为晨起血压模式的异常昼夜血压（BP）节律模式与HFpEF的不良结局相关。
方法与结果
我们对接受动态血压监测（ABPM）的住院心力衰竭患者进行了一项前瞻性观察队列研究。对516例住院心力衰竭患者（年龄69±13岁；男性321例[62%]；女性195例[38%]）进行了中位20.9个月的随访。220例患者观察到了包括全因死亡率和心血管事件在内的复合结局。在Kaplan-Meier分析中，晨起血压模式亚组的复合结局发生率显著高于HFpEF患者的其他亚组（HR，3.01；95%CI：1.54-6.08，P<0.01），但在HFrEF患者中并非如此。
结论
晨起血压模式被发现是HFpEF患者心血管结局的一个新的预测因素。
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