H2FPEF 评分反映左心房应变，可预测射血分数保留心力衰竭患者的预后。
H2FPEF Score Reflects the Left Atrial Strain and Predicts Prognosis in Patients With Heart Failure With Preserved Ejection Fraction.
机构信息
Department of Cardiology, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Gyeonggi, South Korea; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea.
Department of Cardiology, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Gyeonggi, South Korea; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea.
出版信息
J Card Fail. 2021 Feb;27(2):198-207. doi: 10.1016/j.cardfail.2020.09.474. Epub 2020 Oct 7.
BACKGROUND
The HFPEF score is a validated algorithm for the diagnosis of heart failure with preserved ejection fraction (HFpEF). We investigated the associations of the HFPEF score with echocardiographic parameters and prognosis in patients with HFpEF admitted for acute heart failure.
METHODS AND RESULTS
In total, 4312 patients at 3 tertiary centers were identified. Among 1335 patients with HFpEF, the HFPEF score was available in 1105 patients (39% male) with a median age of 77 years (interquartile range 69-82). The median HFPEF score was 4 (interquartile range 3-6). Patients with higher HFPEF scores had worse left atrial (LA) size, peak atrial longitudinal strain of the left atrium, mitral E/e' ratio, and peak tricuspid regurgitation velocity. Peak atrial longitudinal strain of the left atrium demonstrated a significant association with the HFPEF score, in patients without atrial fibrillation and those without atrial fibrillation. After adjustment for clinical factors and echocardiographic parameters, patients with higher HFPEF scores had a higher risk of mortality and hospitalization for heart failure, regardless of the presence of atrial fibrillation.
CONCLUSIONS
The HFPEF score reflects left atrial function in patients with HFpEF admitted for acute heart failure. This association supports the clinical usefulness of the HFPEF score as an indicator of diastolic dysfunction, a diagnostic algorithm for HFpEF, and a prognostic factor in patients with HFpEF.
背景
HFPEF 评分是一种经过验证的算法，用于诊断射血分数保留的心力衰竭（HFpEF）。我们研究了 HFPEF 评分与超声心动图参数和 HFpEF 急性心力衰竭患者预后的相关性。
方法和结果
在 3 个三级中心共确定了 4312 名患者。在 1335 名 HFpEF 患者中，1105 名（39%为男性）患者有 HFPEF 评分，中位年龄为 77 岁（四分位距 69-82）。HFPEF 评分的中位数为 4（四分位距 3-6）。HFPEF 评分较高的患者左心房（LA）大小、左心房峰值纵向应变、二尖瓣 E/e' 比值和三尖瓣反流速度峰值较差。在无房颤和无房颤的患者中，左心房峰值纵向应变与 HFPEF 评分有显著相关性。在调整临床因素和超声心动图参数后，HFPEF 评分较高的患者无论是否存在房颤，其死亡率和心力衰竭住院风险均较高。
结论
HFPEF 评分反映了急性心力衰竭住院的 HFpEF 患者的左心房功能。这种相关性支持 HFPEF 评分作为舒张功能障碍的指标、HFpEF 的诊断算法以及 HFpEF 患者的预后因素的临床实用性。
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