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弯型呼吸困难的发生频率增加与心力衰竭门诊患者的不良预后相关。

Increased frequency of occurrence of bendopnea is associated with poor outcomes in heart failure outpatients.

机构信息

Department of Cardiology, Faculty of Medicine, Canakkale Onsekiz Mart University, Canakkale, Turkey.

Antalya Training and Research Hospital, Cardiology Clinics, Antalya, Turkey.

出版信息

Acta Cardiol. 2021 Oct;76(8):878-886. doi: 10.1080/00015385.2020.1797303. Epub 2020 Aug 19.

Abstract

BACKGROUND

Relationship between the frequency of occurrence of bendopnea during the daily life of heart failure (HF) outpatients and clinical outcomes has never been evaluated before.

METHODS

Turkish Research Team-Heart Failure (TREAT-HF) is a network between HF centres, which undertakes multicentric observational studies in HF. Herein, the data including stable 573 HF patients with reduced ejection fraction out of seven HF centres were presented. A questionnaire was filled by the patients, with the question 'Do you experience shortness of breath while tying your shoelace?', assessing the presence and frequency of bendopnea.

RESULTS

To the question related to bendopnea, 48% of the patients answered 'yes, every time', 31% answered 'yes, sometimes', and 21% answered 'No'. Patients were followed for an average of 24 ± 14 months, and the patients who answered 'yes, every time' and 'yes, sometimes' to the bendopnea question were found having increased risk for both HF-related hospitalisations (HR:3.2,  < .001- HR:2.8,  = .005) and composite outcome consisting of 'HF-related hospitalisations and all-cause death in the multi-variate analysis (HR:3.1,  < .001- HR:3.0,  < .001). Kaplan Meier analysis for HF-related hospitalisation, all-cause death, and the composite of these were provided for these three groups, yielding significant and graded divergence curves with the best prognosis in 'no' group, with the moderate prognosis in 'sometimes' group, and with the worst prognosis in the 'every time' group.

CONCLUSION

For the first time in the literature, our study shows that the increased frequency of bendopnea occurrence in daily life is associated with poor outcomes in HF outpatients.

摘要

背景

心力衰竭(HF)门诊患者日常生活中弯下腰呼吸的发生频率与临床结局之间的关系尚未得到评估。

方法

土耳其研究团队-心力衰竭(TREAT-HF)是一个 HF 中心之间的网络,它进行 HF 的多中心观察性研究。在此,介绍了来自七个 HF 中心的 573 名射血分数降低的稳定 HF 患者的部分数据。患者填写了一份问卷,其中包含一个问题:“系鞋带时是否感到呼吸困难?”,以评估弯腰呼吸的存在和频率。

结果

对于与弯腰呼吸有关的问题,48%的患者回答“每次都有”,31%的患者回答“有时有”,21%的患者回答“没有”。患者平均随访 24±14 个月,对弯腰呼吸问题回答“每次都有”和“有时有”的患者发生 HF 相关住院的风险增加(HR:3.2,<0.001- HR:2.8,=0.005)和复合结局(HF 相关住院和全因死亡的多变量分析(HR:3.1,<0.001- HR:3.0,<0.001)。为这三组患者提供了 HF 相关住院、全因死亡和这些综合结局的 Kaplan-Meier 分析,得出了具有显著和分级差异的曲线,“无”组的预后最好,“有时”组的预后中等,“每次”组的预后最差。

结论

我们的研究首次表明,日常生活中弯腰呼吸发生频率的增加与 HF 门诊患者的不良预后相关。

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