缺血性心脏病患者新发心力衰竭伴射血分数降低或保留的危险因素:一项队列研究

IF 0.2 Q4 MEDICINE, GENERAL & INTERNAL Journal of Clinical Sciences Pub Date : 2021-07-01 DOI:10.4103/jcls.jcls_79_19
S. Abdissa
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引用次数: 0

摘要

背景:埃塞俄比亚和撒哈拉以南非洲缺血性心脏病(IHD)患者的心力衰竭(HF)伴射血分数降低(HFrEF)或HF伴射血分数保留(HFpEF)的危险因素尚不清楚。方法:这是一项队列研究,招募了228例IHD患者,并进行了24个月的回顾性随访。排除标准为基线时已知的心衰和无超声心动图资料。根据患者的基线临床和超声心动图特征,分析HFpEF和HFrEF发生的危险因素。结果:67.1%(153/228)的患者诊断为新发HF。到HF诊断的中位时间HFrEF为12.02(3.42-13.31)个月,HFpEF为12.06(2.66-15.28)个月。HFrEF与HFpEF在HF发生时间上无显著差异。在单因素回归分析中,发生总HF的危险因素是年龄、糖尿病和左心房(LA)大小。糖尿病、收缩压(SBP)、舒张压、LA和舒张左心室尺寸(LVD)与HFrEF有显著相关性。年龄、性别、高血压、收缩压和舒张期LVD与HFpEF显著相关。在cox回归分析中,糖尿病和LA维度与总HF相关,而舒张性LVD与HFpEF和HFrEF相关。年龄、糖尿病和LA尺寸也与HFrEF有关。结论:这些数据表明,年龄、性别、糖尿病、较大的LA大小和舒张期LVD是IHD患者HFrEF和HFpEF的主要预测因素。针对糖尿病、左心室扩张和LA的预防和治疗策略可以预防相当比例的HFrEF或HFpEF。
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Risk factors for new-onset heart failure with reduced or preserved ejection fraction in patients with ischemic heart disease: A cohort study
Background: Risk factors for heart failure (HF) with reduced ejection fraction (HFrEF) or HF with preserved ejection fraction (HFpEF) in Ethiopian and Sub-Saharan African patients with ischemic heart disease (IHD) is not well-known. Methods: This is a cohort study where 228 patients with IHD were recruited and followed retrospectively over 24 months period. Exclusion criteria were known HF at baseline and absence of echocardiography data. From baseline clinical and echocardiographic patient characteristics, risk factors for incident HFpEF and incident HFrEF were analyzed. Results: New-onset HF was diagnosed in 67.1% (153/228) of the patients. Median time to HF diagnosis was 12.02 (3.42–13.31) months in HFrEF and 12.06 (2.66–15.28) months in HFpEF. There was no significant difference between HFrEF and HFpEF in time to incident HF. On univariate regression analysis risk factors for incident total HF were age, diabetes, and left atrium (LA) size. Diabetes, systolic blood pressure (SBP), diastolic blood pressure, LA and diastolic left ventricular dimension (LVD) had significant association with HFrEF. Age, sex, hypertension, SBP, and diastolic LVD were significantly associated with HFpEF. On cox regression analysis diabetes and LA dimension were associated with total HF while diastolic LVD was associated with incident HFpEF and HFrEF. Age, diabetes, and dimension of LA were also associated with HFrEF. Conclusion: These data suggest a major role for age, sex, diabetes, bigger LA size, and diastolic LVD as predictors of HFrEF and HFpEF in patients with IHD. Strategies directed to prevention and treatment of diabetes, dilatation of left ventricle and LA may prevent a considerable proportion of HFrEF or HFpEF.
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来源期刊
Journal of Clinical Sciences
Journal of Clinical Sciences MEDICINE, GENERAL & INTERNAL-
自引率
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发文量
15
审稿时长
45 weeks
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