Institute of Heart Diseases, Medical University, ul. Borowska 213, 50-556, Wroclaw, Poland.
Department of Cardiology, Duke University School of Medicine, Durham, NC, USA.
Sci Rep. 2022 Oct 7;12(1):16889. doi: 10.1038/s41598-022-20525-9.
The aim of this research was to examine the prevalence of hyperventilation (defined by pCO value) among acute heart failure (AHF) patients and to link it with potential triggers and prognosis. All patients underwent dyspnea severity assessment and capillary blood examination on hospital admission and during hospitalization. Out of 241 AHF patients, 57(24%) were assigned to low pCO group (pCO ≤ 30 mmHg) and 184 (76%) to normal pCO group (pCO > 30 mmHg). Low pCO group had significantly lower HCO (22.3 ± 3.4 vs 24.7 ± 2.9 mmol/L, p < 0.0001) and significantly higher lactate level (2.53 ± 1.6 vs 2.14 ± 0.97 mmol/L, p = 0.03). No differences between groups were observed in respect to the following potential triggers of hyperventilation: hypoxia (sO 92.5 ± 5.2 vs 92 ± 5.6% p = 0.57), infection (CRP 10.5[4.9-26.4]vs 7.15[3.45-17.35] mg/L, p = 0.47), dyspnea severity (7.8 ± 2.3vs 8.0 ± 2.3 points, p = 0.59) and pulmonary congestion (82.5 vs 89.1%, p = 0.19), respectively. Low pCO value was related to an increased 4-year all-cause mortality hazard ratio (HR) (95% CI) 2.2 (1.3-3.6); p = 0.002 and risk of death and of rehospitalization for HF, HR (95% CI) 2.0 (1.3-3.0); p = 0.002. Hyperventilation is relatively frequent in AHF and is related to poor prognosis. Low pCO was not contingent on expected potential triggers of dyspnea but rather on tissue hypoperfusion.
本研究旨在探讨急性心力衰竭（AHF）患者过度通气（以 pCO 值定义）的发生率，并将其与潜在诱因和预后联系起来。所有患者在入院时和住院期间均进行呼吸困难严重程度评估和毛细血管血液检查。在 241 例 AHF 患者中，57 例（24%）被分配到低 pCO 组（pCO ≤ 30mmHg），184 例（76%）分到正常 pCO 组（pCO > 30mmHg）。低 pCO 组的 HCO 显著较低（22.3 ± 3.4 对 24.7 ± 2.9mmol/L，p < 0.0001），乳酸水平显著较高（2.53 ± 1.6 对 2.14 ± 0.97mmol/L，p = 0.03）。在过度通气的以下潜在诱因方面，两组之间无差异：缺氧（sO 92.5 ± 5.2 对 92 ± 5.6%，p = 0.57）、感染（CRP 10.5[4.9-26.4]对 7.15[3.45-17.35]mg/L，p = 0.47）、呼吸困难严重程度（7.8 ± 2.3 对 8.0 ± 2.3 分，p = 0.59）和肺充血（82.5 对 89.1%，p = 0.19）。低 pCO 值与 4 年全因死亡风险比（HR）（95%CI）增加 2.2（1.3-3.6）相关（p = 0.002），以及死亡和心力衰竭再住院的风险，HR（95%CI）增加 2.0（1.3-3.0）（p = 0.002）。过度通气在 AHF 中相对常见，与预后不良有关。低 pCO 不是呼吸困难的预期潜在诱因的结果，而是组织灌注不足的结果。
