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心力衰竭与心房颤动:舒张功能差异取决于左心室射血分数

Heart Failure and Atrial Fibrillation: Diastolic Function Differences Depending on Left Ventricle Ejection Fraction.

作者信息

Horodinschi Ruxandra-Nicoleta, Diaconu Camelia Cristina

机构信息

Department 5, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.

Cardiology Clinic, Clinical Emergency Hospital of Bucharest, 014461 Bucharest, Romania.

出版信息

Diagnostics (Basel). 2022 Mar 29;12(4):839. doi: 10.3390/diagnostics12040839.

Abstract

: Heart failure (HF) and atrial fibrillation (AF) are prevalent cardiovascular diseases, and their association is common. Diastolic dysfunction may be present in patients with AF and all types of HF, leading to elevated intracardiac pressures. was to analyze diastolic dysfunction in patients with HF and AF depending on left ventricle ejection fraction (LVEF). : This prospective study included 324 patients with chronic HF and AF (paroxysmal, persistent, or permanent) hospitalized between January 2018 and March 2021. The inclusion criteria were age older than 18 years, diagnosis of chronic HF and AF, and available echocardiographic data. The exclusion criteria were a suboptimal echocardiographic view, other cardiac rhythms than AF, congenital heart disease, or coronavirus 2 infection. Patients were divided into three subgroups according to LVEF: subgroup 1 included 203 patients with HF with reduced ejection fraction (HFrEF) and AF (62.65%), subgroup 2 included 42 patients with HF with mildly reduced ejection fraction (HFmrEF) and AF (12.96%), and subgroup 3 included 79 patients with HF with preserved ejection fraction (HFpEF) and AF (24.38%). We performed 2D transthoracic echocardiography in all patients. Statistical analysis was performed using R software. The E/e' ratio ( = 0.0352, OR 1.9) and left atrial volume index (56.4 mL/m vs. 53.6 mL/m) were higher in patients with HFrEF than in those with HFpEF. : Patients with HFrEF and AF had more severe diastolic dysfunction and higher left ventricular filling pressures than those with HFpEF and AF.

摘要

心力衰竭(HF)和心房颤动(AF)是常见的心血管疾病,它们之间的关联很常见。舒张功能障碍可能存在于房颤患者以及所有类型的心力衰竭患者中,导致心腔内压力升高。目的是根据左心室射血分数(LVEF)分析心力衰竭合并房颤患者的舒张功能障碍情况。方法:这项前瞻性研究纳入了2018年1月至2021年3月期间住院的324例慢性心力衰竭合并房颤(阵发性、持续性或永久性)患者。纳入标准为年龄大于18岁、慢性心力衰竭和房颤的诊断以及可用的超声心动图数据。排除标准为超声心动图图像不理想、除房颤外的其他心律、先天性心脏病或2019冠状病毒感染。根据LVEF将患者分为三个亚组:亚组1包括203例射血分数降低的心力衰竭(HFrEF)合并房颤患者(62.65%),亚组2包括42例射血分数轻度降低的心力衰竭(HFmrEF)合并房颤患者(12.96%),亚组3包括79例射血分数保留的心力衰竭(HFpEF)合并房颤患者(24.38%)。我们对所有患者进行了二维经胸超声心动图检查。使用R软件进行统计分析。HFrEF患者的E/e'比值(=0.0352,OR 1.9)和左心房容积指数(56.4 mL/m² 对比53.6 mL/m²)高于HFpEF患者。结论:HFrEF合并房颤患者比HFpEF合并房颤患者有更严重的舒张功能障碍和更高的左心室充盈压。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5c1/9027500/1c92a6744afa/diagnostics-12-00839-g001.jpg

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