Emanuelsson H, Karlson B W, Herlitz J
Division of Cardiology and Medicine I, Sahlgrenska Hospital, Göteborg, Sweden.
Eur Heart J. 1994 Jun;15(6):761-8. doi: 10.1093/oxfordjournals.eurheartj.a060583.
Congestive heart failure is one of the major symptoms accompanying acute myocardial infarction (AMI). The study aimed to describe the occurrence, characteristics and prognosis of congestive heart failure in AMI and to compare post-MI patients with and without congestive heart failure. The methods used included baseline characteristics, initial symptoms, electrocardiogram (ECG), mortality during hospitalization and one year follow-up in consecutive patients with AMI admitted to Sahlgrenska Hospital, Göteborg, Sweden. Congestive heart failure was observed in 51% of the cases. Patients with congestive heart failure were older, more frequently had a history of previous cardiovascular disease, and, less frequently had chest pain on admission to hospital. They had a higher occurrence of life-threatening ventricular arrhythmias during initial hospitalization, and their mortality during one year follow-up was 39% as compared to 17% in patients without congestive heart failure (P < 0.001). This difference remained significant when correcting for differences at baseline. Patients with severe congestive heart failure had a one year mortality of 47% vs 31% in patients with moderate congestive heart failure (P < 0.01). Signs and symptoms of congestive heart failure occur in every second patient admitted to hospital due to AMI, and indicate a bad prognosis, which is directly related to the severity of congestive heart failure.
充血性心力衰竭是急性心肌梗死（AMI）伴随的主要症状之一。本研究旨在描述AMI患者中充血性心力衰竭的发生率、特征和预后，并比较发生和未发生充血性心力衰竭的心肌梗死后患者。所采用的方法包括瑞典哥德堡萨尔格伦斯卡医院收治的连续AMI患者的基线特征、初始症状、心电图（ECG）、住院期间死亡率和一年随访情况。51%的病例观察到充血性心力衰竭。充血性心力衰竭患者年龄较大，既往有心血管疾病史的频率更高，入院时胸痛的频率更低。他们在初次住院期间发生危及生命的室性心律失常的发生率更高，一年随访期间的死亡率为39%，而无充血性心力衰竭患者的死亡率为17%（P<0.001）。在校正基线差异后，这种差异仍然显著。重度充血性心力衰竭患者的一年死亡率为47%，中度充血性心力衰竭患者为31%（P<0.01）。因AMI入院的患者中，每两名患者就有一名出现充血性心力衰竭的体征和症状，这表明预后不良，且与充血性心力衰竭的严重程度直接相关。
