Yang Hong, Tian Jing, Li Jing, Han Linai, Han Gangfei, Zhao Jinghua, Han Qinghua, Zhang Yanbo
Department of Health Statistics, Shanxi Medical University, Taiyuan, China.
Department of Cardiology, The First Hospital of Shanxi Medical University, Taiyuan, China.
Front Cardiovasc Med. 2022 Sep 20;9:965201. doi: 10.3389/fcvm.2022.965201. eCollection 2022.
Among patients with chronic heart failure (CHF), response shifts are common in assessing treatment effects. However, few studies focused on potential response shifts in these patients.
Data of CHF patient-reported outcome measures (PROMs) were obtained from three hospitals in Shanxi, China, from 2017 to 2019. A total of 497 patients were enrolled and followed up at 1 month and 6 months after discharge. Latent transition analysis (LTA) was employed to determine the longitudinal transition trajectories of latent subtypes in CHF patients in the physiological, psychological, social, and therapeutic domains.
The patients were divided into high- and low-level groups in the four domains according to the LTA. One month after discharge, the physiological and psychological domains improved, while the social and therapeutic domains remained unchanged. Six months after discharge, the former remained stable, but the latter deteriorated. The factors affecting the state transition in four domains were as follows. The influencing factor of the physiological domains are gender, age, tea consumption, smoking, alcohol consumption, physical activity, and light diet; those of the psychological domain are gender, occupation, smoking, alcohol consumption, and physical activity; those of the social domains are age; those of the therapeutic domains are education and income.
The disease status of CHF patients has shifted over time. Risk factors accelerate the deterioration of patients' condition. Furthermore, the risk factors of social and therapeutic domains deteriorate patients' condition faster than those of physiological and psychological domains. Therefore, individualized intervention programs should be given for CHF patients who may be transferred to the low-level groups to maintain the treatment effect and improve the prognosis.
在慢性心力衰竭（CHF）患者中，评估治疗效果时反应转移很常见。然而，很少有研究关注这些患者潜在的反应转移情况。
2017年至2019年从中国山西的三家医院获取CHF患者报告结局测量（PROMs）的数据。共纳入497例患者，并在出院后1个月和6个月进行随访。采用潜在转变分析（LTA）来确定CHF患者在生理、心理、社会和治疗领域潜在亚型的纵向转变轨迹。
根据LTA将患者在四个领域分为高水平组和低水平组。出院1个月后，生理和心理领域有所改善，而社会和治疗领域保持不变。出院6个月后，前者保持稳定，但后者恶化。影响四个领域状态转变的因素如下。生理领域的影响因素有性别、年龄、饮茶、吸烟、饮酒、体育活动和清淡饮食；心理领域的影响因素有性别、职业、吸烟、饮酒和体育活动；社会领域的影响因素是年龄；治疗领域的影响因素是教育程度和收入。
CHF患者的疾病状态随时间发生了变化。危险因素加速了患者病情的恶化。此外，社会和治疗领域的危险因素比生理和心理领域的危险因素更快地使患者病情恶化。因此，对于可能转移到低水平组的CHF患者应给予个体化干预方案，以维持治疗效果并改善预后。
