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合并 COPD 或慢性支气管炎与扩张型心肌病患者预后的关系。

Association between comorbid COPD or chronic bronchitis and the prognosis of patients with Dilated cardiomyopathy.

机构信息

Cardiovascular Disease, Guangzhou University of Chinese Medicine, Guangzhou, China.

Cardiovascular Disease, Guangzhou University of Traditional Chinese Medicine First Affiliated Hospital, Guangzhou, China.

出版信息

Ann Med. 2024 Dec;56(1):2428857. doi: 10.1080/07853890.2024.2428857. Epub 2024 Nov 16.

Abstract

AIMS

Dilated cardiomyopathy (DCM) is characterized by unilateral or bilateral ventricular enlargement and reduced ventricular systolic function, with or without heart failure. In previous studies, we found that a history of chronic obstructive pulmonary disease (COPD) or chronic bronchitis is a high risk factor for DCM combined with pulmonary hypertension (PH). Therefore, we propose that the comorbidity of COPD or chronic bronchitis will increase the cardiogenic mortality of patients with DCM.

METHODS

Data were collected from patients with DCM who were admitted to The First Affiliated Hospital of Guangzhou University of Chinese Medicine from October 2008 to April 2020. The primary endpoint was cardiac death. Multivariable Cox regression analyses were employed to assess the associations between the comorbidities COPD or chronic bronchitis with the study endpoints. Different adjusting models were used to adjust for potential confounders.

RESULTS

A total of 305 DCM patients were ultimately enrolled, among whom 46 patients had COPD or chronic bronchitis. The median follow-up was 50 months. The rate of cardiac death in the COPD or chronic bronchitis group was significantly greater than that in the non-COPD or nonchronic bronchitis group ( < 0.001). The associations between comorbid COPD or chronic bronchitis and cardiac death remained robust after eliminating the possible effects of confounders. After grouping by PH, the risk difference was mainly derived from the intermediate- or high-probability PH group.

CONCLUSIONS

Comorbid COPD or chronic bronchitis increased the risk of cardiac death among DCM patients with an intermediate or high PH probability.

摘要

目的

扩张型心肌病(DCM)的特征为单侧或双侧心室扩大和心室收缩功能降低,伴或不伴心力衰竭。在之前的研究中,我们发现慢性阻塞性肺疾病(COPD)或慢性支气管炎病史是 DCM 合并肺动脉高压(PH)的高危因素。因此,我们提出 COPD 或慢性支气管炎的合并症会增加 DCM 患者的心源性死亡率。

方法

本研究的数据来自于 2008 年 10 月至 2020 年 4 月期间在广州中医药大学第一附属医院就诊的 DCM 患者。主要终点是心脏死亡。多变量 Cox 回归分析用于评估 COPD 或慢性支气管炎合并症与研究终点之间的相关性。使用不同的调整模型来调整潜在的混杂因素。

结果

共纳入 305 例 DCM 患者,其中 46 例患有 COPD 或慢性支气管炎。中位随访时间为 50 个月。COPD 或慢性支气管炎组的心脏死亡发生率明显高于非 COPD 或非慢性支气管炎组(<0.001)。在消除潜在混杂因素的可能影响后,COPD 或慢性支气管炎与心脏死亡之间的关联仍然稳健。在按 PH 分组后,风险差异主要来源于中或高度可能性 PH 组。

结论

COPD 或慢性支气管炎合并症增加了中或高度 PH 可能性 DCM 患者的心脏死亡风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cfbc/11571775/55bb5139428c/IANN_A_2428857_F0001_C.jpg

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