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急性心力衰竭患者的临床特征及预后:来自印度南部单中心心力衰竭登记处的见解

Clinical characteristics and outcomes of patients admitted with acute heart failure: insights from a single-center heart failure registry in South India.

作者信息

Shukkoor Aashiq Ahamed, George Nimmy Elizabeth, Radhakrishnan Shanmugasundaram, Velusamy Sivakumar, Gopalan Rajendiran, Kaliappan Tamilarasu, Anandan Premkrishna, Palanimuthu Ramasamy, Balasubramaniam Vidhyakar, Doraiswamy Vinoth, Ponnusamy Arun Kaushik

机构信息

Department of Cardiology, PSG Institute of Medical Sciences and Research, Coimbatore, Tamilnadu, India.

Department of Pharmacy Practice, PSG College of Pharmacy, Coimbatore, Tamilnadu, India.

出版信息

Egypt Heart J. 2021 May 1;73(1):38. doi: 10.1186/s43044-021-00161-w.

Abstract

BACKGROUND

The epidemiology of HF in India is largely unexplored. Current resources are based on a few hospital-based and a community-based registry from North India. Thus, we present the data from a single hospital-based registry in South India. Patients admitted with acute heart failure over a period of 1 year were enrolled in the registry and were characterized based on their ejection fraction (EF) measured by echocardiogram. The clinical profile of the patients was assessed, including their in-hospital outcomes. One-way ANOVA and univariate analysis were performed for comparison between three EF-based groups and for the assessment of in-hospital outcomes.

RESULTS

A total of 449 patients were enrolled in the registry, of which 296, 90, and 63 patients were categorized as, HFrEF, HFmrEF, and HFpEF, respectively. The prevalence of HFrEF was higher (65.99%). The mean age (SD) of the study cohort was 59.9±13.3. The majority of the patients presented with acute denovo HF (67%) and were more likely to be males (65.9%). The majority of patients presented with warm and wet clinical phenotype (86.4%). In hospital mortality was higher in HFmrEF (3.3%).

CONCLUSION

Patients with HFrEF had high adherence to guideline-directed medical therapy (GDMT). HFrEF patients were also likely to have longer hospital stay along with a worsening of renal function. The in-hospital mortality was comparable between the EF-based groups. Additionally, the association of clinical phenotypes with outcome highlighted that patients in warm and wet phenotype had a longer length of hospital stay, whereas the mortality and worsening renal function rates were found to be significantly higher in the cold and wet group.

摘要

背景

印度心力衰竭(HF)的流行病学情况在很大程度上尚未得到充分研究。目前的资源基于印度北部少数几家医院和社区登记处的数据。因此,我们展示了印度南部一家单一医院登记处的数据。在1年期间因急性心力衰竭入院的患者被纳入登记处,并根据通过超声心动图测量的射血分数(EF)进行特征描述。评估了患者的临床特征,包括他们的住院结局。对基于EF的三个组进行单因素方差分析和单变量分析,以比较各组情况并评估住院结局。

结果

共有449名患者被纳入登记处,其中296例、90例和63例患者分别被归类为射血分数降低的心力衰竭(HFrEF)、射血分数中间值的心力衰竭(HFmrEF)和射血分数保留的心力衰竭(HFpEF)。HFrEF的患病率较高(65.99%)。研究队列的平均年龄(标准差)为59.9±13.3岁。大多数患者表现为急性新发HF(67%),且更可能为男性(65.9%)。大多数患者表现为暖湿临床表型(86.4%)。HFmrEF患者的住院死亡率较高(3.3%)。

结论

HFrEF患者对指南指导的药物治疗(GDMT)的依从性较高。HFrEF患者也可能住院时间更长,同时肾功能恶化。基于EF的各组之间住院死亡率相当。此外,临床表型与结局的关联突出表明,暖湿表型的患者住院时间更长,而冷湿组的死亡率和肾功能恶化率显著更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f1e/8088418/2312ce3ef2f3/43044_2021_161_Fig1_HTML.jpg

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