心力衰竭合并心房颤动患者的临床疗效:哥伦比亚一家心力衰竭门诊的经验。

IF 3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Current Problems in Cardiology Pub Date : 2024-09-04 DOI:10.1016/j.cpcardiol.2024.102841
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引用次数: 0

摘要

背景:多达 60% 的心力衰竭患者会同时伴有心房颤动,从而增加住院率和死亡率。本研究根据左心室射血分数(LVEF)分析了心衰合并心房颤动患者的临床特征、治疗、住院和死亡率:这项回顾性队列研究纳入了 2020-2022 年间麦德林(哥伦比亚)心力衰竭门诊的患者。根据射血分数将患者分为两组:射血分数降低(LVEF≤40%)和射血分数轻度降低或保留(LVEF>40%)。评估结果为随访期间的住院率和死亡率。此外,还分析了入院时和最后一次随访时的B型钠尿肽(BNP)值、LVEF值以及根据纽约心脏病协会(NYHA)划分的功能分级:研究共纳入185名患者,其中51.9%为男性,中位年龄为80岁(IQR:74-86)。与入院时的数值相比,无论左心收缩功能如何,NYHA功能分级、B型钠尿肽水平和LVEF均有整体改善。3.2%的患者接受了心房颤动消融术,29%的患者接受了房室结消融的心脏设备植入术。在左心室射血分数方面,住院率和死亡率没有发现明显的统计学差异:心力衰竭合并心房颤动患者的压缩性最佳治疗需要药物治疗、消融策略、心脏设备、心血管康复和密切随访。在该队列中,不同左心室射血分数的住院率和死亡率相似,NYHA功能分级和BNP水平也有所改善。
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Clinical outcomes of patients with heart failure and atrial fibrillation: Experience from an outpatient heart failure clinic in Colombia

Background

Heart failure (HF) can coexist with atrial fibrillation in up to 60 % of cases, increasing rates of hospitalizations and death. This study analyzed the clinical characteristics, treatment, hospitalization, and mortality of patients with HF and atrial fibrillation based on left ventricular ejection fraction (LVEF).

Methods

A retrospective cohort study included patients from an outpatient HF clinic at Medellín (Colombia) between 2020-2022. Patients were classified into two groups according to LVEF: reduced (LVEF≤40 %) and mildly reduced or preserved ejection fraction (LVEF>40 %). The evaluated outcomes were hospitalization and mortality during follow-up. Values for B-type natriuretic peptide (BNP), LVEF and functional class according to the New York Heart Association (NYHA) were also analyzed at admission and during the last follow-up visit.

Results

The study included 185 patients, with 51.9% being male. The median age of the participants was 80 years (interquartile range [IQR] 74 - 86). There was an overall improvement in the NYHA functional class, BNP levels, and LVEF compared with the baseline values, irrespective of left systolic function. Atrial fibrillation ablation was performed in 3.2 % of patients, and cardiac device implantation with atrioventricular node ablation in 29 %. No statistically significant differences were found in terms of hospitalization and mortality regarding left systolic function.

Conclusion

Compressive optimal treatment for patients with HF and atrial fibrillation requires pharmacological treatment, ablation strategies, cardiac devices, cardiovascular rehabilitation and close follow-up. In this cohort, hospitalization and mortality rates were similar according to LVEF categories and there was improvement in NYHA functional class and BNP level.

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来源期刊
Current Problems in Cardiology
Current Problems in Cardiology 医学-心血管系统
CiteScore
4.80
自引率
2.40%
发文量
392
审稿时长
6 days
期刊介绍: Under the editorial leadership of noted cardiologist Dr. Hector O. Ventura, Current Problems in Cardiology provides focused, comprehensive coverage of important clinical topics in cardiology. Each monthly issues, addresses a selected clinical problem or condition, including pathophysiology, invasive and noninvasive diagnosis, drug therapy, surgical management, and rehabilitation; or explores the clinical applications of a diagnostic modality or a particular category of drugs. Critical commentary from the distinguished editorial board accompanies each monograph, providing readers with additional insights. An extensive bibliography in each issue saves hours of library research.
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