Spinar J, Vítovec J, Spinarová L, Toman J
II. interní klinika FN U sv. Anny, Brno.
Vnitr Lek. 1996 Jan;42(1):43-8.
The relationship between baseline clinical, laboratory and auxiliary indicators on the one-year mortality was investigated in 125 patients with chronic heart failure caused by ischaemic heart disease or cardiomyopathy associated with dilatation. During the baseline examination all patients had cardiac symptoms-functional class NYHA II-IV- and their ejection fraction assessed by echocardiography was < 40% and/or their cardiothoracic index was > 50%. Within twelve months after the baseline examination 19 (15.2%) patients died. Signs of pulmonary congestion and the cardiothoracic index were the most significant prognostic indicator of the one-year mortality (p < 0.001). As to other indicators, the following were statistically significant: sodium level, urea level, the duration of the ergometric test and the patients' body weight. Statistical significance was not recorded in echocardiographic indicators and the NYHA classification. These data, in particular the newly introduced four-grade classification of pulmonary congestion, make it possible to assess a more accurate prognosis of high risk patients with chronic heart failure.
在125例由缺血性心脏病或扩张型心肌病引起的慢性心力衰竭患者中,研究了基线临床、实验室和辅助指标与一年死亡率之间的关系。在基线检查期间,所有患者均有心脏症状(NYHA心功能分级II-IV级),通过超声心动图评估的射血分数<40%和/或心胸指数>50%。在基线检查后的十二个月内,19例(15.2%)患者死亡。肺淤血体征和心胸指数是一年死亡率最显著的预后指标(p<0.001)。至于其他指标,以下指标具有统计学意义:钠水平、尿素水平、运动试验持续时间和患者体重。超声心动图指标和NYHA分级未记录到统计学意义。这些数据,特别是新引入的肺淤血四级分类,使得评估慢性心力衰竭高危患者的预后更加准确成为可能。