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心力衰竭并恢复射血分数患者的预后和舒张功能障碍预测因子。

Prognosis and diastolic dysfunction predictors in patients with heart failure and recovered ejection fraction.

机构信息

Department of Cardiology, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo, 162-8666, Japan.

Institute of Advanced Biomedical Engineering and Science, Tokyo Women's Medical University, Tokyo, Japan.

出版信息

Sci Rep. 2022 May 24;12(1):8768. doi: 10.1038/s41598-022-12823-z.

Abstract

There is limited data on whether diastolic dysfunction in patients with heart failure (HF) and recovered ejection fraction (HFrecEF) is associated with worse prognosis. We retrospectively assessed 96 patients diagnosed with HFrecEF and created ROC curve of their diastolic function at the 1-year follow-up for the composite endpoint of cardiovascular death and HF readmission after the follow-up. Eligible patients were divided into two groups according to the cutoff value of E/e' ratio (12.1) with the highest AUC (0.70). Kaplan-Meier analysis showed that HFrecEF with high E/e' group had a significantly poorer prognosis than the low E/e' group (log-rank, p = 0.01). Multivariate Cox regression analysis revealed that the high E/e' group was significantly related to the composite endpoint (hazard ratio 5.45, 95% confidence interval [CI] 1.23-24.1). The independent predictors at discharge for high E/e' ratio at the 1-year follow-up were older age and female sex after adjustment for covariates (odds ratio [OR] 1.07, 95% CI 1.01-1.13 and OR 4.70, 95% CI 1.08-20.5). In conclusion, HFrecEF with high E/e' ratio might be associated with a poor prognosis. Older age and female sex were independent predictors for a sustained high E/e' ratio in patients with HFrecEF.

摘要

在射血分数恢复的心力衰竭(HFrecEF)患者中,舒张功能障碍是否与预后不良相关的数据有限。我们回顾性评估了 96 例诊断为 HFrecEF 的患者,并在随访 1 年后为其舒张功能创建了 ROC 曲线,用于随访后心血管死亡和 HF 再入院的复合终点。根据 E/e' 比值(12.1)的最高 AUC(0.70),将符合条件的患者分为两组。Kaplan-Meier 分析表明,E/e'高的 HFrecEF 组预后明显差于 E/e'低的组(对数秩检验,p=0.01)。多变量 Cox 回归分析显示,E/e'高的组与复合终点显著相关(危险比 5.45,95%置信区间[CI]1.23-24.1)。在调整协变量后,E/e'高的患者在 1 年随访时的独立预测因子为年龄较大和女性(比值比[OR]1.07,95%CI1.01-1.13 和 OR 4.70,95%CI1.08-20.5)。总之,E/e'高的 HFrecEF 可能与预后不良相关。年龄较大和女性是 HFrecEF 患者持续 E/e'高的独立预测因子。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d50b/9130289/80bcdd3652a5/41598_2022_12823_Fig1_HTML.jpg

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