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老年高血压患者射血分数保留的心力衰竭的发病率及危险因素

Incidence and risk factors of heart failure with preserved ejection fraction in elderly patients with hypertension.

作者信息

Chen Min, Li Wentao, Ran Qin

机构信息

Department of cardiovascular medicine, Chengdu Seventh People's Hospital, No.1188 Shuangxing Avenue, Chengdu city, 610200, Sichuan Province, China.

Department of Internal Medicine, West China Second Hospital, Sichuan University, No. 1416 Chenglong Avenue, Chengdu city, 610041, Sichuan Province, China.

出版信息

BMC Cardiovasc Disord. 2024 Dec 23;24(1):742. doi: 10.1186/s12872-024-04419-4.

DOI:10.1186/s12872-024-04419-4
PMID:39716088
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11665201/
Abstract

BACKGROUND

Heart failure with preserved ejection fraction (HFpEF) poses a significant clinical challenge, especially in older patients with HT. This study aimed to identify the factors influencing HFpEF occurrence in elderly patients with HT.

METHODS

Elderly patients with HT were categorized into two groups: no HFpEF group and HFpEF group based on HFpEF diagnosis. Demographic, clinical, laboratory and echocardiographic data was conducted. Logistic regression analysis and joint prediction modeling were used to identify predictive factors for HFpEF.

RESULTS

Several factors were associated with HFpEF, including age, body mass index, duration of HT, atrial fibrillation (AF), chronic kidney disease (CKD), stroke, systolic blood pressure (SBP), serum creatinine (SCr), N-terminal pro brain natriuretic peptide (NT-proBNP), heart rate, serum sodium, low density lipoprotein cholesterol (LDL-c), triglyceride, left ventricular ejection fraction (LVEF), E/e' ratio, left atrial diameter, tricuspid regurgitation velocity, mitral regurgitation and C-reactive protein (CRP) levels. The joint prediction model shown high accuracy, with an area under the curve (AUC) of 0.840.

CONCLUSIONS

This study provided insights into the incidence rate and risk factors of HFpEF in elderly patients with HT. Key determinants included age, blood pressure, biomarkers, and echocardiographic parameters.

摘要

背景

射血分数保留的心力衰竭(HFpEF)带来了重大的临床挑战,尤其是在老年高血压患者中。本研究旨在确定影响老年高血压患者发生HFpEF的因素。

方法

根据HFpEF诊断,将老年高血压患者分为两组:无HFpEF组和HFpEF组。收集人口统计学、临床、实验室和超声心动图数据。采用逻辑回归分析和联合预测模型来确定HFpEF的预测因素。

结果

几个因素与HFpEF相关,包括年龄、体重指数、高血压病程、心房颤动(AF)、慢性肾脏病(CKD)、中风、收缩压(SBP)、血清肌酐(SCr)、N末端脑钠肽前体(NT-proBNP)、心率、血清钠、低密度脂蛋白胆固醇(LDL-c)、甘油三酯、左心室射血分数(LVEF)、E/e'比值、左心房直径、三尖瓣反流速度、二尖瓣反流和C反应蛋白(CRP)水平。联合预测模型显示出较高的准确性,曲线下面积(AUC)为0.840。

结论

本研究为老年高血压患者HFpEF的发病率和危险因素提供了见解。关键决定因素包括年龄、血压、生物标志物和超声心动图参数。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2293/11665201/c5505aa58e3d/12872_2024_4419_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2293/11665201/c5505aa58e3d/12872_2024_4419_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2293/11665201/c5505aa58e3d/12872_2024_4419_Fig1_HTML.jpg

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本文引用的文献

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Heart failure with preserved ejection fraction: everything the clinician needs to know.射血分数保留的心力衰竭:临床医生需要了解的一切。
Lancet. 2024 Mar 16;403(10431):1083-1092. doi: 10.1016/S0140-6736(23)02756-3. Epub 2024 Feb 14.
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How to Manage Heart Failure With Preserved Ejection Fraction: Practical Guidance for Clinicians.射血分数保留的心力衰竭的管理:临床医生的实用指南。
JACC Heart Fail. 2023 Jun;11(6):619-636. doi: 10.1016/j.jchf.2023.03.011. Epub 2023 May 3.
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Heart Failure With Preserved Ejection Fraction: JACC Scientific Statement.
射血分数保留的心力衰竭:美国心脏病学会杂志科学声明。
J Am Coll Cardiol. 2023 May 9;81(18):1810-1834. doi: 10.1016/j.jacc.2023.01.049. Epub 2023 Apr 19.
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Heart Failure With Preserved Ejection Fraction: A Review.射血分数保留的心力衰竭:综述。
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Heart Failure with Preserved Ejection Fraction: Concise Review.射血分数保留的心力衰竭:简要综述。
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SGLT2 Inhibitors and Heart Failure with Preserved Ejection Fraction.钠-葡萄糖协同转运蛋白 2 抑制剂与射血分数保留的心力衰竭。
Heart Fail Clin. 2022 Oct;18(4):579-586. doi: 10.1016/j.hfc.2022.03.010.
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Efficacy and Safety of Dapagliflozin in Heart Failure With Mildly Reduced or Preserved Ejection Fraction According to Age: The DELIVER Trial.达格列净在射血分数轻度降低或保留的心力衰竭中的疗效和安全性:DELIVER 试验。
Circ Heart Fail. 2022 Oct;15(10):e010080. doi: 10.1161/CIRCHEARTFAILURE.122.010080. Epub 2022 Aug 27.
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Management of Atrial Fibrillation Across the Spectrum of Heart Failure With Preserved and Reduced Ejection Fraction.管理射血分数保留和降低的心力衰竭中的各种心房颤动。
Circulation. 2022 Jul 26;146(4):339-357. doi: 10.1161/CIRCULATIONAHA.122.057444. Epub 2022 Jul 25.
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