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胸腔超声识别的胸腔积液可预测急性失代偿性心力衰竭患者的生活质量较差。

Pleural effusions identified by thoracic ultrasound predict poor quality of life in patients with acute decompensated heart failure.

机构信息

Pleura and Thoracic Ultrasound Unit, Pulmonary and Critical Care Service, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico; Internal Medicine Department, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico.

Internal Medicine Department, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico.

出版信息

Heart Lung. 2024 Nov-Dec;68:279-283. doi: 10.1016/j.hrtlng.2024.08.008. Epub 2024 Aug 17.

Abstract

INTRODUCTION

Pleural effusion (PE) is a common manifestation of acute decompensated heart failure (ADHF); however, its influence on the quality of life (QoL) is unknown.

OBJECTIVES

To identify whether PE detected using thoracic ultrasound (TUS) is associated with poorer QoL in patients with ADHF and a reduced ejection fraction (≤40 %).

METHODS

We conducted a prospective, longitudinal, descriptive, observational, single-center study at a university hospital in Mexico. We included participants with a reduced left ventricular ejection fraction who were admitted for ADHF. We performed TUS and the Minnesota Living with Heart Failure Questionnaire (MLHFQ) within the first 48 h of hospitalization.

RESULTS

Forty patients with ADHF (30 males and 10 females; mean age, 51.24 ± 16.942 years) were included in this study. The participants were categorized into two groups: those with (n = 25, 62.5 %) or without (n = 15, 37.5 %) PE on TUS. We found a statistically significant association between the presence of PEs and a worse perception of QoL. The mean MLHFQ score in the group of patients with PEs was 40 points, compared to 12 points in the group without PEs (p < 0.001). Poorer QoL was associated with a higher quantity of pleural fluid, as evidenced by the greater number of intercostal spaces occupied by the PE (p < 0.001).

CONCLUSIONS

Patients with ADHF and a reduced ejection fraction who present with PE have a worse perception of QoL than patients without PE.

摘要

简介

胸腔积液(PE)是急性失代偿性心力衰竭(ADHF)的常见表现;然而,其对生活质量(QoL)的影响尚不清楚。

目的

确定使用胸部超声(TUS)检测到的胸腔积液是否与射血分数降低(≤40%)的 ADHF 患者的 QoL 较差相关。

方法

我们在墨西哥的一所大学医院进行了一项前瞻性、纵向、描述性、观察性、单中心研究。我们纳入了射血分数降低并因 ADHF 入院的患者。我们在入院后 48 小时内进行 TUS 和明尼苏达州心力衰竭生活质量问卷(MLHFQ)。

结果

这项研究共纳入了 40 名 ADHF 患者(30 名男性和 10 名女性;平均年龄为 51.24 ± 16.942 岁)。参与者分为两组:TUS 检查有胸腔积液(n = 25,62.5%)或无胸腔积液(n = 15,37.5%)。我们发现 TUS 检查有胸腔积液与 QoL 较差存在统计学显著关联。胸腔积液组患者的平均 MLHFQ 评分为 40 分,而无胸腔积液组患者的平均 MLHFQ 评分为 12 分(p < 0.001)。胸腔积液量越多,QoL 越差,胸腔积液占据的肋间隙数量也越多(p < 0.001)。

结论

与无胸腔积液的患者相比,射血分数降低的 ADHF 患者出现胸腔积液时对 QoL 的感知更差。

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