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射血分数保留的心力衰竭住院患者中,三尖瓣反流峰值速度与1年内心力衰竭再入院之间的关联。

The association between peak tricuspid regurgitation velocity and 1-year heart failure readmission in hospitalised patients with heart failure with preserved ejection fraction.

作者信息

Wang Tianbo, Liu Xiaohan, Zhang Yue, Fang Chenli, Xu Junbo

机构信息

Department of Cardiology, The Third People's Hospital of Chengdu, College of Medicine, Southwest Jiaotong University, Chengdu 610031, Sichuan, PR China.

出版信息

Acta Cardiol. 2025 May;80(3):217-224. doi: 10.1080/00015385.2024.2421638. Epub 2024 Nov 19.

Abstract

BACKGROUND

This study aimed to evaluate the association between peak tricuspid regurgitation velocity (TRV) and 1-year heart failure (HF) readmission in hospitalised patients with HF with preserved ejection fraction (HFpEF) because the impact of peak TRV on the short-term prognosis of these patients has been unclear.

METHODS

From January 2020 to December 2021, 513 hospitalised HFpEF patients age ≥ 60 years with 1-year follow-up were included in this study. Peak TRV was classified as normal (≤ 2.8 m/s) and high (> 2.8 m/s) value according to pulmonary hypertension probability.

RESULTS

Approximately 68.23% of HFpEF patients had a high peak TRV value. In the final adjusted Cox regression model, peak TRV was still independently associated with HF readmission (HR: 1.74, 95% CI: 1.19-2.55,  = 0.004). Furthermore, patients with high peak TRV were also associated with an increased risk of HF readmission (HR: 2.30, 95% CI: 1.31-4.04,  = 0.004), compared to those with normal peak TRV. After inverse probability of weighting, the risk of HF readmission in patients with high peak TRV was 2.53 (95% CI: 1.35-4.75,  = 0.004) compared to those with normal peak TRV. Additionally, Subgroup analysis revealed very elderly patients, male, and patients with hypertension had a significantly worse prognosis.

CONCLUSION

Peak TRV is independently associated with HF readmission in hospitalised HFpEF patients. High peak TRV has a higher risk of HF readmission in patients age ≥ 80 years, male and patients with hypertension, indicating that special attention should be paid to these patients.

摘要

背景

本研究旨在评估射血分数保留的心力衰竭(HFpEF)住院患者的三尖瓣反流峰值速度(TRV)与1年内心力衰竭(HF)再入院之间的关联,因为TRV峰值对这些患者短期预后的影响尚不清楚。

方法

2020年1月至2021年12月,本研究纳入了513例年龄≥60岁且有1年随访的HFpEF住院患者。根据肺动脉高压可能性,将TRV峰值分类为正常(≤2.8米/秒)和高值(>2.8米/秒)。

结果

约68.23%的HFpEF患者TRV峰值较高。在最终调整的Cox回归模型中,TRV峰值仍与HF再入院独立相关(风险比:1.74,95%置信区间:1.19-2.55,P=0.004)。此外,与TRV峰值正常的患者相比,TRV峰值高的患者HF再入院风险也增加(风险比:2.30,95%置信区间:1.31-4.04,P=0.004)。在进行逆概率加权后,与TRV峰值正常的患者相比,TRV峰值高的患者HF再入院风险为2.53(95%置信区间:1.35-4.75,P=0.004)。此外,亚组分析显示,高龄患者、男性和高血压患者的预后明显更差。

结论

TRV峰值与HFpEF住院患者的HF再入院独立相关。TRV峰值高的患者,年龄≥80岁、男性和高血压患者HF再入院风险更高,表明应特别关注这些患者。

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