一项基于人群的研究中射血分数正常心力衰竭患者的转归  

Outcome of heart failure with preserved ejection fraction in a population-based study

作　　者：Bhatia R.S. Lee D.S. 孙凯 

出　　处：《世界核心医学期刊文摘（心脏病学分册）》2007年第2期11-12,共2页

摘　　要：背景:射血分数正常心力衰竭的重要性日益受到重视。进行一项研究来评价射血分数正常心力衰竭患者的流行病学特点和转归,并与射血分数降低心力衰竭患者进行比较。方法:1999年4月1日至2001年3月31日,对2802例就诊于加拿大安大略省103家医院、出院诊断为心力衰竭的患者进行研究,已对其射血分数进行了评价。Background: The importance of heart failure with preserved ejection fraction is increasingly recognized. We conducted a study to evaluate the epidemiologic features and outcomes of patients with heart failure with preserved ejection fraction and to compare the findings with those from patients who had heart failure with reduced ejection fraction. Methods: From April 1, 1999, through March 31, 2001, we studied 2802 patients admitted to 103 hospitals in the province of Ontario, Canada, with a discharge diagnosis of heart failure whose ejection fraction had also been assessed. The patients were categorized in three groups: those with an ejection fraction of less than 40 percent(heart failure with reduced ejection fraction), those with an ejection fraction of 40 to 50 percent(heart failure with borderline ejection fraction), and those with an ejection fraction of more than 50 percent(heart failure with preserved ejection fraction). Two groups were studied in detail: those with an ejection fraction of less than 40 percent and those with an ejection fraction of more than 50 percent. The main outcome measures were death within one year and readmission to the hospital for heart failure. Results: Thirty-one percent of the patients had an ejection fraction of more than 50 percent. Patients with heart failure with preserved ejection fraction were more likely to be older and female and to have a history of hypertension and atrial fibrillation. The presenting history and clinical examination findings were similar for the two groups. The unadjusted mortality rates for patients with an ejection fraction of more than 50 percent were not significantly different from those for patients with an ejection fraction of less than 40 percent at 30 days(5 percent vs. 7 percent, P=0.08) and at 1 year(22 percent vs. 26 percent, P=0.07); the adjusted one-year mortality rates were also not significantly different in the two groups(hazard ratio, 1.13; 95 percent confidence interval, 0.94 to 1.36; P=0.18). The rates of readmission for heart fai

关 键 词：射血分数 出院诊断 安大略省 日至 房颤病史 再次住院率 现病史 校正死亡率 无显著性差异 临界值 

分 类 号：R541.6[医药卫生—心血管疾病]