Sajeev Chakanalil Govindan, Rajan Nair Shreetal, George Biju, Rajesh Gopalan Nair, Krishnan Mangalath Narayanan
Department of Cardiology Government Medical College Calicut India.
Department of Community Medicine Government Medical College Calicut India.
ESC Heart Fail. 2017 Feb;4(1):16-22. doi: 10.1002/ehf2.12119. Epub 2016 Oct 7.
The aims of the study were to study the demographical and clinicopathological characteristics of patients presenting with heart failure and evaluate the 1 year outcomes and to identify risk predictors if any.
A prospective observational study was conducted in consecutive patients of systolic heart failure. The study was divided into two parts-an initial 6 month enrolment phase followed up for 1 year for major adverse cardiovascular events. All patients were treated according to the Institutional Heart Failure Protocol. Demographical and clinicopathophysiological characteristics were studied, and results were analysed. A total of 143 patients were enrolled. The mean age of subjects was 56.4 years with male subjects constituting almost two-thirds of the study population. The commonest aetiology of heart failure was ischemic with valvular heart disease being the commonest cause of non-ischemic heart failure. Bendopnea, a recently described symptom of heart failure, was found in a significant number of subjects. By univariate analysis, male sex ( = 0.042) and cardiomegaly ( = 0.035) were predictors of rehospitalization, whereas the univariate predictors of mortality were ischemic aetiology ( = 0.000), age > 50 years ( = 0.007), hypertension ( = 0.012), worsening NYHA class ( = 0.003), diabetes mellitus ( = 0.009), and hypokalaemia ( = 0.006). Multivariate analysis performed showed age > 50 years [ = 0.007; OR (CI) = 13.547 (2.034-90.238)], NYHA class [ = 0.002; OR (CI) = 32.300 (3.733-276.532)], and hypokalaemia [ = 0.031; OR (CI) = 7.524 (1.208-46.862)] as significant predictors of mortality during long-term follow-up.
The study will definitely help us to throw more light in identifying risk predictors of heart failure and help in improving clinical outcomes.
本研究旨在探讨心力衰竭患者的人口统计学和临床病理特征，评估1年结局，并确定（若有）风险预测因素。
对连续性收缩性心力衰竭患者进行前瞻性观察研究。该研究分为两个部分——最初6个月的入组阶段，随后对主要不良心血管事件进行1年随访。所有患者均按照机构心力衰竭方案进行治疗。研究了人口统计学和临床病理生理特征，并对结果进行了分析。共纳入143例患者。受试者的平均年龄为56.4岁，男性受试者占研究人群的近三分之二。心力衰竭最常见的病因是缺血性，瓣膜性心脏病是最常见的非缺血性心力衰竭病因。在相当数量的受试者中发现了新近描述的心力衰竭症状——端坐呼吸。单因素分析显示，男性（P = 0.042）和心脏扩大（P = 0.035）是再住院的预测因素，而死亡的单因素预测因素为缺血性病因（P = 0.000）、年龄>50岁（P = 0.007）、高血压（P = 0.012）、纽约心脏协会（NYHA）心功能分级恶化（P = 0.003）、糖尿病（P = 0.009）和低钾血症（P = 0.006）。多因素分析显示，年龄>50岁[P = 0.007；比值比（可信区间）= 13.547（2.034 - 90.238）]、NYHA心功能分级[P = 0.002；比值比（可信区间）= 32.300（3.733 - 276.532）]和低钾血症[P = 0.031；比值比（可信区间）= 7.524（1.208 - 46.862）]是长期随访期间死亡的显著预测因素。
本研究肯定有助于我们更清楚地识别心力衰竭的风险预测因素，并有助于改善临床结局。
