Silva Lopes Bruno, Craveiro Nuno, Firmino-Machado João, Ribeiro Pedro, Castelo-Branco Miguel
Tondela-Viseu Hospital Center, Physical and Rehabilitation Medicine Department, Avenida Rei D. Duarte, Viseu, 3504-509, Portugal.
Lusitana Family Health Unit, Viseu, Portugal.
Ther Adv Cardiovasc Dis. 2019 Jan-Dec;13:1753944719876517. doi: 10.1177/1753944719876517.
Impedance cardiography is a reliable, well-tolerated, and non-invasive method used to obtain hemodynamic measurements and could potentially be useful in heart failure (HF) diagnosis, hemodynamic monitoring of critically ill patients, and help in the choice of antihypertensive therapy. The objective of this study was to determine the differences between hemodynamic parameters in a study population of hypertensive patients with and without HF, using impedance cardiography.
A case-control study was designed and named the TARGET study. Participants were enrolled in two study groups: control group C, hypertensive patients without HF and the HF group, hypertensive patients with HF. A descriptive analysis was carried out to characterize the sample and differences in continuous variables were tested for statistical significance by independent sample test.
The study included 102 hypertensive outpatients. The control group consisted of 77 individuals (58.4% males; mean age 63.9 ± 12.5 years old) and the HF group consisted of 25 individuals (44.0% males; mean age 74.2 ± 8.7 years old). The mean Cardiac Index (CI) was 2.70 ± 1.02 L.min.m (2.89 ± 1.04 2.12 ± 0.70; < 0.001), mean Stroke Index (SI) was 35.5 ± 14.7 mL.m (37.7 ± 15.2 28.5 ± 10.8; = 0.006), mean Ejection Phase Contractility Index (EPCI) was 33.7 ± 12.7 1000 s (35.8 ± 13.1 27.2 ± 9.2; = 0.003), mean Inotropic State Index (ISI) was 74.3 ± 28.2 100 s (78.8 ± 28.9 60.6 ± 20.7; = 0.005), and mean Left Stroke Work Index (LSWI) was 51.3 ± 23.1 g.min.m (55.4 ± 23.5 38.9 ± 16.6; = 0.002).
In this study, hypertensive patients with HF had significantly lower values of blood flow parameters, contractility, and left work indices compared with hypertensive patients without HF. These differences reflected the incorrect hemodynamic pattern (mostly hypodynamic) of these patients. Impedance cardiography (ICG) seems to be an adequate method to reflect these differences.
阻抗心动图是一种可靠、耐受性良好的非侵入性方法，用于获取血流动力学测量值，可能有助于心力衰竭（HF）的诊断、危重症患者的血流动力学监测以及辅助选择抗高血压治疗方案。本研究的目的是使用阻抗心动图确定有HF和无HF的高血压患者研究人群中血流动力学参数的差异。
设计了一项病例对照研究，命名为TARGET研究。参与者被纳入两个研究组：对照组C，无HF的高血压患者和HF组，有HF的高血压患者。进行了描述性分析以描述样本特征，并通过独立样本检验对连续变量的差异进行统计学显著性检验。
该研究纳入了102名高血压门诊患者。对照组由77人组成（男性占58.4%；平均年龄63.9±12.5岁），HF组由25人组成（男性占44.0%；平均年龄74.2±8.7岁）。平均心脏指数（CI）为2.70±1.02L.min.m²（2.89±1.04对2.12±0.70；P<0.001），平均每搏指数（SI）为35.5±14.7mL.m²（37.7±15.2对28.5±10.8；P=0.006），平均射血期收缩性指数（EPCI）为33.7±12.7×1000/s（35.8±13.1对27.2±9.2；P=0.003），平均变力状态指数（ISI）为74.3±28.2×100/s（78.8±28.9对60.6±20.7；P=0.005），平均左心室搏功指数（LSWI）为51.3±23.1g.min.m²（55.4±23.5对38.9±16.6；P=0.002）。
在本研究中，与无HF的高血压患者相比，有HF的高血压患者的血流参数、收缩性和左心室作功指数值显著更低。这些差异反映了这些患者不正确的血流动力学模式（主要是低动力型）。阻抗心动图（ICG）似乎是反映这些差异的一种合适方法。
