重度恰加斯病性心力衰竭的预后因素

Prognostic Factors in Severe Chagasic Heart Failure.

作者信息

Costa Sandra de Araújo, Rassi Salvador, Freitas Elis Marra da Madeira, Gutierrez Natália da Silva, Boaventura Fabiana Miranda, Sampaio Larissa Pereira da Costa, Silva João Bastista Masson

机构信息

Universidade Federal de Goiás, Goiânia, GO, Brazil.

出版信息

Arq Bras Cardiol. 2017 Mar;108(3):246-254. doi: 10.5935/abc.20170027.

DOI:10.5935/abc.20170027

PMID:28443956

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5389874/

Abstract

BACKGROUND

Prognostic factors are extensively studied in heart failure; however, their role in severe Chagasic heart failure have not been established.

OBJECTIVES

To identify the association of clinical and laboratory factors with the prognosis of severe Chagasic heart failure, as well as the association of these factors with mortality and survival in a 7.5-year follow-up.

METHODS

60 patients with severe Chagasic heart failure were evaluated regarding the following variables: age, blood pressure, ejection fraction, serum sodium, creatinine, 6-minute walk test, non-sustained ventricular tachycardia, QRS width, indexed left atrial volume, and functional class.

RESULTS

53 (88.3%) patients died during follow-up, and 7 (11.7%) remained alive. Cumulative overall survival probability was approximately 11%. Non-sustained ventricular tachycardia (HR = 2.11; 95% CI: 1.04 - 4.31; p<0.05) and indexed left atrial volume ≥ 72 mL/m2 (HR = 3.51; 95% CI: 1.63 - 7.52; p<0.05) were the only variables that remained as independent predictors of mortality.

CONCLUSIONS

The presence of non-sustained ventricular tachycardia on Holter and indexed left atrial volume > 72 mL/m2 are independent predictors of mortality in severe Chagasic heart failure, with cumulative survival probability of only 11% in 7.5 years.

摘要

背景

心力衰竭的预后因素已得到广泛研究；然而，它们在严重恰加斯病性心力衰竭中的作用尚未明确。

目的

确定临床和实验室因素与严重恰加斯病性心力衰竭预后的关联，以及这些因素与7.5年随访中的死亡率和生存率的关联。

方法

对60例严重恰加斯病性心力衰竭患者进行了以下变量的评估：年龄、血压、射血分数、血清钠、肌酐、6分钟步行试验、非持续性室性心动过速、QRS波宽度、左心房容积指数和心功能分级。

结果

53例（88.3%）患者在随访期间死亡，7例（11.7%）存活。累积总生存概率约为11%。非持续性室性心动过速（HR = 2.11；95%CI：1.04 - 4.31；p<0.05）和左心房容积指数≥72 mL/m2（HR = 3.51；95%CI：1.63 - 7.52；p<0.05）是仅有的仍作为死亡率独立预测因素的变量。