Martin S A, Coughlin S S, Metayer C, René A A, Hammond I W
Department of Biostatistics and Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA.
J Natl Med Assoc. 1996 Nov;88(11):734-43.
Although bronchial asthma and emphysema have been associated with idiopathic dilated cardiomyopathy in case-control studies, little is known about the prognostic importance of chronic respiratory disease in idiopathic dilated cardiomyopathy. To study this, we examined history of bronchial asthma, emphysema and chronic bronchitis, and respiratory medication use as possible predictors of survival in idiopathic dilated cardiomyopathy using data from a Washington, DC, population-based study (n = 129). The cumulative survival rates among patients with a history of emphysema or chronic bronchitis were 60% and 48% at 12 and 36 months, respectively, compared with 81.8% and 67.2% among patients without emphysema or chronic bronchitis. The survival rates of idiopathic dilated cardiomyopathy patients with and without a history of bronchial asthma at the time of idiopathic dilated cardiomyopathy diagnosis were similar. In multivariate analysis using the proportional hazards model, only ventricular arrhythmias and ejection fraction were found to be statistically significant predictors of survival in idiopathic dilated cardiomyopathy. The adjusted relative risk estimate for emphysema and chronic bronchitis was close to one. Thus, the results of this population-based study do not suggest that history of chronic respiratory illness is an independent predictor of survival in idiopathic dilated cardiomyopathy.
尽管在病例对照研究中支气管哮喘和肺气肿已与特发性扩张型心肌病相关,但对于慢性呼吸道疾病在特发性扩张型心肌病中的预后重要性却知之甚少。为研究这一问题,我们利用来自华盛顿特区一项基于人群的研究(n = 129)的数据,调查了支气管哮喘、肺气肿和慢性支气管炎病史以及呼吸药物使用情况,将其作为特发性扩张型心肌病患者生存的可能预测因素。有肺气肿或慢性支气管炎病史的患者在12个月和36个月时的累积生存率分别为60%和48%,而无肺气肿或慢性支气管炎的患者这一比例分别为81.8%和67.2%。在特发性扩张型心肌病诊断时,有和无支气管哮喘病史的特发性扩张型心肌病患者的生存率相似。在使用比例风险模型的多变量分析中,仅发现室性心律失常和射血分数是特发性扩张型心肌病患者生存的统计学显著预测因素。肺气肿和慢性支气管炎的调整后相对风险估计值接近1。因此,这项基于人群的研究结果并不表明慢性呼吸道疾病史是特发性扩张型心肌病患者生存的独立预测因素。