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视觉评估二尖瓣与三尖瓣开放时间差对急性心力衰竭患者的预后价值

The Prognostic Value of the Visually Assessed Time Difference between Mitral Valve and Tricuspid Valve Opening Score for Patients with Acute Heart Failure.

作者信息

Yue Yin, Wu Xiaopeng, Qi Dan, Liu Wenting, Zhang Jianjun

机构信息

Department of Cardiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100043, China.

出版信息

Acta Cardiol Sin. 2025 May;41(3):382-406. doi: 10.6515/ACS.202505_41(3).20250106E.

Abstract

OBJECTIVE

The aim of this study was to investigate the prognostic value of visually assessed time difference between mitral valve and tricuspid valve opening (VMT) score in patients with acute heart failure (AHF).

METHODS

Potential confounding factors associated with all-cause and cardiovascular disease (CVD)-cause mortality in AHF patients were explored using a univariate Cox regression model, and the relationship between the VMT score and all-cause/CVD-cause mortality was analyzed using a multivariable Cox regression model. Hazard ratios (HRs) and 95% confidence intervals (CIs) were used as the effect size. The prognostic value of the VMT score was evaluated using the C-index.

RESULTS

The all-cause mortality rate and CVD-cause mortality rate in the VMT score < 2 group were lower than in the VMT score ≥ 2 group. VMT score > 2 was correlated with an elevated risk of all-cause mortality in the AHF patients (HR = 1.97, 95% CI: 1.20-3.25). An increased risk of CVD-cause mortality was observed in the VMT score > 2 group. The C-index of the VMT score for all-cause mortality in the AHF patients was 0.621 (95% CI: 0.570-0.672), while for CVD-cause mortality it was 0.644 (95% CI: 0.573-0.715). Combining the VMT score with variables associated with all-cause mortality and CVD-cause mortality, the C-index of the VMT score-based model for all-cause mortality in the AHF patients was 0.859 (95% CI: 0.820-0.898), while for CVD-cause mortality it was 0.872 (95% CI: 0.825-0.919).

CONCLUSIONS

The VMT score showed moderate prognostic value for all-cause and CVD-cause mortality in patients with AHF. Combining the VMT score with other related variables resulted in good prognostic value for all-cause and CVD-cause mortality in patients with AHF.

摘要

目的

本研究旨在探讨急性心力衰竭(AHF)患者中,通过视觉评估二尖瓣与三尖瓣开放时间差(VMT)评分的预后价值。

方法

使用单变量Cox回归模型探究与AHF患者全因死亡和心血管疾病(CVD)所致死亡相关的潜在混杂因素,并使用多变量Cox回归模型分析VMT评分与全因/CVD所致死亡之间的关系。风险比(HRs)和95%置信区间(CIs)用作效应量。使用C指数评估VMT评分的预后价值。

结果

VMT评分<2组的全因死亡率和CVD所致死亡率低于VMT评分≥2组。VMT评分>2与AHF患者全因死亡风险升高相关(HR = 1.97,95% CI:1.20 - 3.25)。VMT评分>2组观察到CVD所致死亡风险增加。AHF患者全因死亡的VMT评分C指数为0.621(95% CI:0.570 - 0.672),而CVD所致死亡的C指数为0.644(95% CI:0.573 - 0.715)。将VMT评分与全因死亡和CVD所致死亡相关变量相结合,基于VMT评分的AHF患者全因死亡模型的C指数为0.859(95% CI:0.820 - 0.898),而CVD所致死亡的C指数为0.872(95% CI:0.825 - 0.919)。

结论

VMT评分对AHF患者的全因和CVD所致死亡显示出中等预后价值。将VMT评分与其他相关变量相结合,对AHF患者的全因和CVD所致死亡具有良好的预后价值。

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