左心房容积指数对轻、中度慢性心力衰竭预后的价值  

Prognostic value of left atrial volume index in patients with mild to moderate chronic heart failure

作　　者：廖凯[1] 杨成明[1] 曾春雨[1] 方玉强[1] 储伟[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所心血管内科,重庆400042

出　　处：《第三军医大学学报》2010年第2期173-175,共3页Journal of Third Military Medical University

摘　　要：目的评价左心房容积指数(left atrial volume index,LAVi)对轻、中度慢性心力衰竭(chronic heart failure,CHF)患者预后的预测价值。方法选择完成随访的轻、中度CHF患者110例,采用单平面、面积-长度法测量LAVi,随访(17.0±4.2)个月。结果全模型多元Logistic回归分析显示:LAVi与是否发生终点事件明显相关(P=0.045),LAVi每增加1 ml/m2,风险增加4.8%(95%CI为1.001～1.096),LAVi水平对预后判定的ROC曲线下面积为0.851,敏感度为85.7%,特异度为75.6%。结论LAVi对轻、中度CHF患者发生心血管事件或死亡的预测具有一定的价值。Objective To analyze the prognostic value of left atrial volume index（LAVi） in patients with mild to moderate chronic heart failure.Methods Totally 110 chronic heart failure who admitted in our department from Sep.2007 to Mar.2008 and followed up for（17.0±4.2） months were enrolled in this study,including 38 cases of hypertensive heart disease,17 cases of dilated cardiomyopathy and 10 cases of valvular diseases.They were（63.3±10.6） years old,and there were 65 cases of Ⅱ grade and 45 cases of Ⅲ grade according to New York heart association（NYHA）.Their mean left ventricular ejection fraction（LVEF） was 51%,and that for 64 patients with heart failure with normal ejection fraction was 58.2%.Resting cardiac output（CO）,6-minute walk test（6MWT） and exercise CO were measured.Levels of LAVi were measured by monoplane,area-length method.Results Logistic regression analysis showed that an increased hazard of death and/or rehospitalization had variables association with LAVi.LAVi was strongly associated with adverse outcome,with a 4.8% increase in risk for every 1 ml/m2 of LAVi（95%CI 1.001 to 1.096,P0.05）.Area under the curve for LAVi in evaluating prognosis of CHF patients was 0.851（sensitivity 85.5%,specificity 75.6%）.Conclusion LAVi level on admission is a strong predictor for rehospitalization and death in patients with mild to moderate chronic heart failure.

关 键 词：慢性心力衰竭 左心房容积指数 预后 

分 类 号：R331.31[医药卫生—人体生理学] R449[医药卫生—基础医学]