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八旬老人射血分数中度降低和保留的心力衰竭的临床特征:一项多中心观察性研究的结果

Clinical features of heart failure with mid-range and preserved ejection fraction in octogenarians: Results of a multicentre, observational study.

作者信息

Özlek Bülent, Özlek Eda, Tekinalp Mehmet, Kahraman Serkan, Ağuş Hicaz Zencirkıran, Çelik Oğuzhan, Çil Cem, Kaya Bedri Caner, Rencüzoğulları İbrahim, Mert Kadir Uğur, Çakır Mustafa Ozan, Ösken Altuğ, Bekar Lütfü, Çelik Yunus, Başaran Özcan, Doğan Volkan, Mert Gurbet Özge, Sancar Kadriye Memiç, Sevinç Samet, Biteker Murat

机构信息

Department of Cardiology, Mugla Sitki Kocman University Training and Research Hospital, Mugla, Turkey.

Department of Cardiology, Kahramanmaras Necip Fazıl City Hospital, Kahramanmaras, Turkey.

出版信息

Int J Clin Pract. 2019 Apr;73(4):e13341. doi: 10.1111/ijcp.13341. Epub 2019 Mar 21.

Abstract

OBJECTIVES

To compare real-world characteristics and management of individuals aged 80 and older with heart failure (HF) and mid-range ejection fraction (HFmrEF) and heart failure with preserved ejection fraction (HFpEF) derived from a large cohort of survey and to compare them with those younger than 80 from the same survey.

METHODS

This is an observational, multicentre and cross-sectional study conducted in Turkey (NCT03026114). Consecutive 1065 (mean age of 67.1 ± 10.6 years) patients admitted to the cardiology outpatient units with HFmrEF and HFpEF were included.

RESULTS

Participants aged 80 and older (n = 123, 11.5%) were more likely to be female (66.7% vs 52.5%, P = 0.003), had a higher prevalence of atrial fibrillation (49.6% vs 34%, P = 0.001), and anaemia (46.3% vs 33.4%, P = 0.005) than those who were younger than 80. N-terminal pro B-type natriuretic peptide levels were higher in those aged 80 and older than in those younger than 80 (1037 vs 550 pg/ml, P < 0.001). The prescription rates of HF medications (including in ACE-Is/ARBs, β-blockers, MRAs, digoxin, ivabradine and diuretics) were similar (P > 0.05) in both groups. Octogenarians did not significantly differ from younger patients in the prevalence of HFmrEF (24.4% vs 22.9%) and HFpEF (75.6% vs 77.1%). Coronary artery disease was associated with HFmrEF (P < 0.05), whereas atrial fibrillation was associated with HFpEF (P < 0.05) in octogenarians.

CONCLUSIONS

This study revealed that nearly 12% of the individuals with HFmrEF and HFpEF in this real-world sample were aged 80 and older. Participants aged 80 and older are more likely to be female and have more comorbidities than those who were younger than 80. However, HF medication profiles were similar in both groups. This study also showed that associated factors with HFmrEF and HFpEF were differ in octogenarians.

摘要

目的

比较来自大规模调查队列中80岁及以上心力衰竭(HF)伴中度射血分数(HFmrEF)和射血分数保留的心力衰竭(HFpEF)患者的真实世界特征及管理情况,并将其与同一项调查中80岁以下患者进行比较。

方法

这是一项在土耳其开展的观察性、多中心横断面研究(NCT03026114)。纳入连续1065例因HFmrEF和HFpEF入住心脏病门诊的患者(平均年龄67.1±10.6岁)。

结果

80岁及以上参与者(n = 123,11.5%)比80岁以下者更可能为女性(66.7%对52.5%,P = 0.003),心房颤动患病率更高(49.6%对34%,P = 0.001),贫血患病率更高(46.3%对33.4%,P = 0.005)。80岁及以上者N末端B型利钠肽原水平高于80岁以下者(1037对550 pg/ml,P < 0.001)。两组HF药物(包括ACE-Is/ARBs、β受体阻滞剂、MRAs、地高辛、伊伐布雷定和利尿剂)的处方率相似(P > 0.05)。80岁及以上者与年轻患者在HFmrEF患病率(2

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