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心肌缺血所致心力衰竭患者的生活质量

Quality of Life of Patients with Heart Failure Due to Myocardial Ischemia.

作者信息

Bonek-Wytrych Grażyna, Sierka Oskar, Szynal Magdalena, Dąbek Józefa

机构信息

College of Doctoral School, Faculty of Health Sciences in Katowice, Medical University of Silesia in Katowice, 40-752 Katowice, Poland.

College of Doctoral School, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, 40-752 Katowice, Poland.

出版信息

Rev Cardiovasc Med. 2024 Sep 24;25(9):342. doi: 10.31083/j.rcm2509342. eCollection 2024 Sep.

Abstract

BACKGROUND

Heart failure caused by myocardial ischemia is a common cause encountered in clinical practice. A significant problem in heart failure is its progressive, unfavorable course and the associated increased frequency of repeated hospitalizations, as well as a significant deterioration in the functioning of patients, leading to their inability to function independently and a significant decline in the quality of life. This study aimed to assess the quality of life of patients with heart failure due to myocardial ischemia, considering the left ventricular ejection fraction, the number of "diseased" coronary arteries, co-occurring diseases, and cardiovascular risk factors.

METHODS

A total of 204 patients with decompensated heart failure due to chronic myocardial ischemia were included in this study and examined twice: A: on the first day of hospitalization; A': from 4 to 8 weeks. For the individual assessment of the quality of life, the WHOQOL-BREF (The World Health Organization Quality of Life - BREF) questionnaire was used.

RESULTS

In the group of patients with heart failure in the decompensation stage a statistically significant positive relationship was observed between the number of comorbidities and the social domain (R(A) = 0.197; (A) = 0.005), the number of diseased coronary arteries and the mental (R(A) = 0.184; (A) = 0.184) and environmental (R(A) = 0.149; (A) = 0.034) domains, left ventricular ejection fraction (LVEF%) and quality of life (R(A) = 0.235; = 0.001) and satisfaction with health (R(A) = 0.235; = 0.001) and somatic domain (R(A) = 0.194; = 0.005). A similar result was observed among patients in the long-term follow-up. A statistically significant negative correlation was demonstrated in the mentioned group between the LVEF% value and the social domain (R(A) = -0.235; = 0.001), as well as in the long-term follow-up (R(A') = -0.191, = 0.026). The level of self-assessment of quality of life and satisfaction with health was statistically significantly higher among patients with heart failure in the long-term follow-up (3.20 ± 0.62) than in patients in the decompensation stage (1.98 ± 0.69).

CONCLUSIONS

The quality of life of the examined patients with heart failure caused by chronic myocardial ischemia was poor, although it improved to average in the long-term follow-up. It was determined by left ventricular ejection fraction, the number of "diseased" coronary arteries, comorbidities, and risk factors.

摘要

背景

心肌缺血所致心力衰竭是临床实践中常见的病因。心力衰竭的一个重要问题是其呈进行性、不良病程,以及反复住院频率增加,同时患者功能显著恶化,导致无法独立生活且生活质量大幅下降。本研究旨在评估心肌缺血所致心力衰竭患者的生活质量,同时考虑左心室射血分数、“病变”冠状动脉数量、合并疾病及心血管危险因素。

方法

本研究共纳入204例因慢性心肌缺血导致失代偿性心力衰竭的患者,并进行了两次检查:A:住院第一天;A':4至8周后。采用世界卫生组织生活质量简表(WHOQOL - BREF)对生活质量进行个体评估。

结果

在失代偿期心力衰竭患者组中,合并症数量与社会领域之间存在统计学显著正相关(R(A)=0.197;P(A)=0.005),病变冠状动脉数量与心理领域(R(A)=0.184;P(A)=0.018)和环境领域(R(A)=0.149;P(A)=0.034)之间存在正相关,左心室射血分数(LVEF%)与生活质量(R(A)=0.235;P = 0.001)、对健康的满意度(R(A)=0.235;P = 0.001)以及躯体领域(R(A)=0.194;P = 0.005)之间存在正相关。在长期随访患者中也观察到了类似结果。在上述组中,LVEF%值与社会领域之间存在统计学显著负相关(R(A)= - 0.235;P = 0.001),在长期随访中也是如此(R(A') = - 0.191,P = 0.026)。长期随访的心力衰竭患者生活质量自我评估水平和对健康的满意度(3.20±0.62)在统计学上显著高于失代偿期患者(1.98±0.69)。

结论

经检查的慢性心肌缺血所致心力衰竭患者生活质量较差,不过在长期随访中有所改善,达到了平均水平。其生活质量由左心室射血分数、“病变”冠状动脉数量、合并症及危险因素决定。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36c0/11440393/a9ca3d212c78/2153-8174-25-9-342-g1.jpg

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