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血红蛋白是男性非缺血性心肌病患者运动耐量改善的独立预测因子。

Hemoglobin is an independent predictor of improvement exercise tolerance in male patients with non-ischemic cardiomyopathy.

机构信息

Department of Cardiovascular Medicine, Osaka Metropolitan University Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan.

出版信息

Heart Vessels. 2024 May;39(5):412-426. doi: 10.1007/s00380-024-02358-w. Epub 2024 Feb 27.

Abstract

Exercise intolerance is a symptom of chronic heart failure (CHF). The magnitude of exercise tolerance, as measured by peak oxygen uptake (peak VO), is strongly associated with prognosis in patients with CHF. We aimed to evaluate the factors associated with improved exercise tolerance in patients with HF. In this prospective study, we recruited patients who were diagnosed with non-ischemic cardiomyopathy between September 2017 and September 2021. All patients underwent cardiopulmonary exercise testing at discharge and 6 months after enrollment. The patients were stratified according to whether peak VO was increased or not at 6 months. One hundred patients with a reduced left-ventricular ejection fraction (LVEF < 50%) were enrolled. Improvement of peak VO was observed in 74 patients. In male patients, hemoglobin level was higher in the increased peak VO group than in the non-increased group (15.0 ± 1.9 g/dL vs. 13.1 ± 2.1 g/dL; p < 0.01). Baseline hemoglobin level was positively correlated with the percentage change in peak VO (Spearman's r = 0.248, p = 0.040). Kaplan-Meier analysis demonstrated that adverse cardiac events were significantly less frequent in the increased peak VO group than in the non-increased group (log-rank test, p = 0.032). Multivariate logistic regression analysis identified hemoglobin level as an independent predictor of improved peak VO [odds ratio (OR) 1.60; 95% confidence interval (CI) 1.05-2.44; p = 0.027]. Baseline hemoglobin level is an independent predictor of improved peak VO in male patients with non-ischemic cardiomyopathy.

摘要

运动不耐受是慢性心力衰竭(CHF)的症状。最大摄氧量(peak VO)测量的运动耐量与 CHF 患者的预后密切相关。我们旨在评估与 HF 患者运动耐量改善相关的因素。在这项前瞻性研究中,我们招募了 2017 年 9 月至 2021 年 9 月期间被诊断为非缺血性心肌病的患者。所有患者在出院时和入组后 6 个月时进行心肺运动测试。根据 6 个月时 peak VO 是否增加,将患者分层。共纳入 100 例左心室射血分数(LVEF<50%)降低的患者。74 例患者的 peak VO 得到改善。在男性患者中,增加 peak VO 组的血红蛋白水平高于未增加组(15.0±1.9 g/dL 比 13.1±2.1 g/dL;p<0.01)。基线血红蛋白水平与 peak VO 变化百分比呈正相关(Spearman r=0.248,p=0.040)。Kaplan-Meier 分析表明,增加 peak VO 组的不良心脏事件发生率明显低于未增加组(对数秩检验,p=0.032)。多变量逻辑回归分析确定血红蛋白水平是改善 peak VO 的独立预测因子[优势比(OR)1.60;95%置信区间(CI)1.05-2.44;p=0.027]。基线血红蛋白水平是男性非缺血性心肌病患者 peak VO 改善的独立预测因子。

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