González-Guerrero José Luis, Paredes-Galán Emilio, Ferrero-Martínez Ana Isabel, Galán María Concepción, Hornillos-Calvo Mercedes, Menéndez-Colino Rocío, Torres-Torres Ivett, Rodríguez-Artalejo Fernando, Rodríguez-Pascual Carlos
Servicio de Geriatría, Complejo Hospitalario Universitario de Cáceres, Cáceres, España.
Servicio de Cardiología, Complejo Hospitalario Universitario de Vigo, Vigo, España.
Rev Esp Geriatr Gerontol. 2020 Jul-Aug;55(4):195-200. doi: 10.1016/j.regg.2019.12.001. Epub 2020 Feb 17.
The latest European Society of Cardiology Heart Failure (HF) guidelines define three types of HF according to the ejection fraction (EF): HF with reduced EF (HFrEF) when EF<40%, HF with mid-range EF (HFmrEF), when EF 40-49%, and HF with preserved EF (HFpEF) when EF≥50%. The objective of this study was to analyse the characteristics and results of elderly patients hospitalised with HF according to the new classification using EF.
A prospective study was carried out with 531 HF patients aged ≥75 years classified according to EF, and admitted in the geriatric wards of 6 hospitals in Spain. An analysis was performed on the demographic and clinical characteristics, as well as well as the morbidity and mortality at one year of follow-up.
As regards EF, 17.1% had HFrEF, 10% had HFmrEF, and 72.9% had HFpEF. Patients with HFmrEF were more similar to those with HFrEF in terms of a younger age, predominance of men, and previous admission due to HF. This was also the case with the use of drugs for neurohormonal blockade. Patients with HFrEF (compared to those with HFmrEF and HFpEF), had higher mortality (35.2%, 24.5%, and 25.6%, respectively), more readmissions for HF (17.6%, 15.1%, and 14.5%, respectively), and more events (61.5%, 45.3%, and 52.5%, respectively), although there were no significant differences. There were also no differences observed in the survival analysis between the EF groups and the time-dependent outcome variables.
In elderly patients hospitalised with HF, those classified as HFmrEF did not show any clear differences with respect to those with HFrEF or HFpEF. There were no differences in terms of morbidity and mortality.
欧洲心脏病学会最新的心力衰竭(HF)指南根据射血分数(EF)将心力衰竭分为三种类型:射血分数降低的心力衰竭(HFrEF),即EF<40%;射血分数中等范围的心力衰竭(HFmrEF),即EF为40 - 49%;射血分数保留的心力衰竭(HFpEF),即EF≥50%。本研究的目的是根据使用EF的新分类方法分析老年心力衰竭住院患者的特征和结果。
对531例年龄≥75岁的心力衰竭患者进行了一项前瞻性研究,这些患者根据EF进行分类,并入住西班牙6家医院的老年病房。对人口统计学和临床特征以及随访一年时的发病率和死亡率进行了分析。
在EF方面,17.1%为HFrEF,10%为HFmrEF,72.9%为HFpEF。HFmrEF患者在年龄较小、男性占主导以及既往因心力衰竭入院方面与HFrEF患者更为相似。在使用神经激素阻滞剂药物方面也是如此。HFrEF患者(与HFmrEF和HFpEF患者相比)死亡率更高(分别为35.2%、24.5%和25.6%),因心力衰竭再次入院的比例更高(分别为17.6%、15.1%和14.5%),事件发生率更高(分别为61.5%、45.3%和52.5%),尽管没有显著差异。在EF组与时间依赖性结局变量之间的生存分析中也未观察到差异。
在老年心力衰竭住院患者中,分类为HFmrEF的患者与HFrEF或HFpEF患者相比未显示出任何明显差异。在发病率和死亡率方面没有差异。