视诊二尖瓣和三尖瓣开口时间差评分对射血分数轻度降低心力衰竭患者的预后价值。

The prognostic value of the visually assessed time difference between mitral valve and tricuspid valve opening score for patients with heart failure with mildly reduced ejection fraction.

机构信息

Department of Cardiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.

出版信息

Clin Cardiol. 2024 Feb;47(2). doi: 10.1002/clc.24223.

DOI:10.1002/clc.24223

PMID:38402565

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10823457/

Abstract

BACKGROUND

The visually assessed time difference between the mitral valve and tricuspid valve opening (VMT) score was correlated with the increase of left ventricular filling pressure (LVFP).

HYPOTHESIS

We suspected that the VMT score might be a valuable prognostic biomarker for heart failure with mildly reduced ejection fraction (HFmrEF) patients. This study was to evaluate the predictive value of VMT score for 1-year all-cause and cardiovascular disease (CVD)-cause mortality in HFmrEF patients.

METHODS

This cohort study enrolled 379 patients aged ≥18 years old with HFmrEF. Univariable and multivariable Cox regression analysis was employed to assess the association between VMT score and all-cause or CVD-cause mortality in HFmrEF patients. Hazards ratio (HR), and 95% confidence interval (CI) were effect sizes. Kaplan-Meier curves showed the survival probability of patients. The area under the curve (AUC) evaluated the prognostic value of the VMT score.

RESULTS

The risk of all-cause mortality was increased in HFmrEF patients in the VMT score of 2 (HR = 2.80, 95%CI: 1.04-7.52) and 3 (HR = 4.29, 95%CI: 1.58-11.66). The VMT score of 3 was associated with an increased risk of 1-year CVD-cause mortality in patients with HFmrEF (HR = 7.63, 95%CI: 1.70-34.33). The AUC of VMT score for predicting 1-year all-cause mortality of HFmrEF patients was 0.724, and for predicting 1-year CVD-cause mortality of HFmrEF patients was 0.748. The survival probability of patients with the VMT score < 2 was higher than those with the VMT score of 2 and 3.

CONCLUSION

The VMT score might be a reliable prognostic index for 1-year all-cause or CVD-cause mortality of HFmrEF patients.

摘要

背景

二尖瓣和三尖瓣开口的视觉评估时间差（VMT）评分与左心室充盈压（LVFP）的增加相关。

假说

我们怀疑 VMT 评分可能是射血分数轻度降低的心力衰竭（HFmrEF）患者的有价值的预后生物标志物。本研究旨在评估 VMT 评分对 HFmrEF 患者 1 年全因和心血管疾病（CVD）死亡率的预测价值。

方法

这项队列研究纳入了 379 名年龄≥18 岁的 HFmrEF 患者。采用单变量和多变量 Cox 回归分析评估 VMT 评分与 HFmrEF 患者全因或 CVD 死亡率之间的关系。风险比（HR）和 95%置信区间（CI）为效应大小。Kaplan-Meier 曲线显示了患者的生存概率。曲线下面积（AUC）评估了 VMT 评分的预后价值。

结果

VMT 评分为 2 分（HR=2.80，95%CI：1.04-7.52）和 3 分（HR=4.29，95%CI：1.58-11.66）的 HFmrEF 患者全因死亡率风险增加。VMT 评分 3 分与 HFmrEF 患者 1 年 CVD 死亡率风险增加相关（HR=7.63，95%CI：1.70-34.33）。VMT 评分预测 HFmrEF 患者 1 年全因死亡率的 AUC 为 0.724，预测 HFmrEF 患者 1 年 CVD 死亡率的 AUC 为 0.748。VMT 评分<2 的患者的生存概率高于 VMT 评分为 2 和 3 的患者。