老年慢性肾脏病患者的心力衰竭与左心室功能障碍：中国高血压调查（2012 - 2015年）
Heart failure and left ventricular dysfunction in older patients with chronic kidney disease: the China Hypertension Survey (2012-2015).
作者信息
Wang Xin, Hao Guang, Chen Lu, Zhang Lin-Feng, Chen Zuo, Kang Yu-Ting, Yang Ying, Zheng Cong-Yi, Zhou Hao-Qi, Wang Zeng-Wu, Gao Run-Lin
机构信息
Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Epidemiology, School of Medicine, Jinan University, Guangzhou, China.
出版信息
J Geriatr Cardiol. 2020 Oct 28;17(10):597-603. doi: 10.11909/j.issn.1671-5411.2020.10.001.
BACKGROUND
Heart failure (HF) is a leading cause of hospitalization and mortality for older chronic kidney disease (CKD) patients. However, the epidemiological data is scarce. We aimed to determine the prevalence of left ventricular (LV) dysfunction and HF, and to explore the risk factors for HF among those patients.
METHODS
This is a cross-sectional analysis of the China Hypertension Survey conducted between October 2012 and December 2015. A total of 5, 808 participants aged ≥ 65 years were included in the analysis. Self-reported history of HF and any other cardiovascular diseases was acquired. 2-D and Doppler echocardiography were used to assess LV dysfunction. CKD was defined as either estimated glomerular filtration rate (eGFR) < 60 mL/min per 1.73 m or urinary albumin to creatinine ratio (ACR) ≥ 30 mg/g.
RESULTS
Among CKD patients aged ≥ 65 years, the weighted prevalence of HF, heart failure with preserved ejection fraction (HFpEF), heart failure with mid-range ejection fraction (HFmrEF), and heart failure with reduced ejection fraction (HFrEF) was 4.8%, 2.5%, 0.8%, and 1.7%, respectively. The weighted prevalence of HF was 5.0% in patients with eGFR < 60 mL/min per 1.73 m, and was 5.9% in patients with ACR ≥ 30 mg/g. The prevalence of LV systolic dysfunction was 3.1%, and while it was 8.9% for moderate/severe diastolic dysfunction. Multivariate analysis showed that smoking was significantly associated with the risk of HF. Furthermore, age, smoking, and residents in rural areas were significantly associated with a risk of LV diastolic dysfunction.
CONCLUSIONS
The prevalence of HF and LV dysfunction was high in older patients with CKD, suggesting that particular strategies will be required.
背景
心力衰竭（HF）是老年慢性肾脏病（CKD）患者住院和死亡的主要原因。然而，流行病学数据匮乏。我们旨在确定左心室（LV）功能障碍和HF的患病率，并探讨这些患者中HF的危险因素。
方法
这是一项对2012年10月至2015年12月期间进行的中国高血压调查的横断面分析。共有5808名年龄≥65岁的参与者纳入分析。获取了HF和任何其他心血管疾病的自我报告病史。使用二维和多普勒超声心动图评估LV功能障碍。CKD定义为估算肾小球滤过率（eGFR）<60 mL/（min·1.73 m²）或尿白蛋白与肌酐比值（ACR）≥30 mg/g。
结果
在年龄≥65岁的CKD患者中，HF、射血分数保留的心力衰竭（HFpEF）、射血分数中等范围的心力衰竭（HFmrEF）和射血分数降低的心力衰竭（HFrEF）的加权患病率分别为4.8%、2.多变量分析显示，吸烟与HF风险显著相关。此外，年龄、吸烟和农村居民与LV舒张功能障碍风险显著相关。
结论
老年CKD患者中HF和LV功能障碍的患病率较高，提示需要采取特定策略。 5%、0.8%和1.7%。eGFR<60 mL/（min·1.73 m²）的患者中HF的加权患病率为5.0%，ACR≥30 mg/g的患者中为5.9%。LV收缩功能障碍的患病率为3.1%，而中度/重度舒张功能障碍的患病率为8.9%。
Zotero 插件