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舒张应变参数与晚期心力衰竭患者的短期死亡率和再住院率相关。

Diastolic Strain Parameters are Associated with Short Term Mortality and Rehospitalization in Patients with Advanced Heart Failure.

机构信息

Necmettin Erbakan Universitesi - Kardiyoloji, Konya - Turquia.

Konya City Hospital, Konya - Turquia.

出版信息

Arq Bras Cardiol. 2024 Aug;121(8):e20230670. doi: 10.36660/abc.20230670.

Abstract

BACKGROUND

Heart failure (HF) is a leading cause of hospitalization and mortality worldwide and places a great economic burden on healthcare systems. Identification of prognostic factors in HF patients is of great importance to establish optimal management strategies and to avoid unnecessary invasive and costly procedures in end-stage patients.

OBJECTIVES

In the current study, we aimed to investigate the association between diastolic strain parameters including E/e' SR, and short-term outcomes in advanced HF patients.

METHODS

The population study included 116 advanced HF with reduced ejection fraction (HFrEF) patients. Clinical, laboratory, and echocardiographic evaluations of the patients were performed within the first 24 hours of hospital admission. Patients were followed for one month and any re-hospitalization due to worsening of HF symptoms and any mortality was recorded. The level of significance adopted in the statistical analysis was 5%.

RESULTS

E/e' SR was significantly higher in the patient group compared to the control group (p=0.001). During one-month follow-up, 13.8% of patients died and 37.1% of patients were rehospitalized. Serum NT-ProBNP (p=0.034) and E/e' SR (p=0.033) were found to be independent predictors of mortality and ACEİ use (p=0.027) and apical 3C strain (p=0.011) were found to be independent predictors of rehospitalization in the patient group.

CONCLUSION

Findings of the current prospective study demonstrate that E/e' SR measured by speckle tracking echocardiography is an independent and sensitive predictor of short-term mortality in advanced HFrEF patients and may have a role in the identification of end-stage HFrEF patients.

摘要

背景

心力衰竭(HF)是全球范围内导致住院和死亡的主要原因,给医疗保健系统带来了巨大的经济负担。识别 HF 患者的预后因素对于制定最佳管理策略非常重要,并且可以避免终末期患者进行不必要的侵入性和昂贵的治疗。

目的

在本研究中,我们旨在探讨舒张应变参数(包括 E/e' SR)与晚期 HF 患者短期预后的关系。

方法

这项人群研究纳入了 116 例射血分数降低的心力衰竭(HFrEF)晚期患者。在入院后 24 小时内对患者进行临床、实验室和超声心动图评估。对患者进行为期一个月的随访,记录因 HF 症状恶化而再次住院和任何死亡的情况。在统计分析中采用的显著性水平为 5%。

结果

与对照组相比,患者组的 E/e' SR 明显更高(p=0.001)。在一个月的随访期间,有 13.8%的患者死亡,37.1%的患者再次住院。血清 NT-ProBNP(p=0.034)和 E/e' SR(p=0.033)被发现是死亡率的独立预测因子,ACEİ 药物的使用(p=0.027)和心尖 3C 应变(p=0.011)被发现是再住院的独立预测因子。

结论

本前瞻性研究的结果表明,斑点追踪超声心动图测量的 E/e' SR 是晚期 HFrEF 患者短期死亡率的独立和敏感预测因子,可能有助于识别终末期 HFrEF 患者。

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