RAVI联合Tp-Te对CSHF患者预后的预测价值  

Predictive value of RAVI combined with Tp-Te for prognosis in CSHF patients

作　　者：李颖[1] 宋军晓 曲雪凌 LI Ying;SONG Jun-xiao;QU Xue-ling(Department of Cardiac Ultrasound,Weihai Municipal Hospital,Cheeloo College of Medicine,Shandong University,Weihai,Shandong,264200,China)

机构地区：[1]山东大学附属威海市立医院心脏超声科,山东威海264200 [2]山东大学附属威海市立医院超声科,山东威海264200

出　　处：《心血管康复医学杂志》2025年第1期66-71,共6页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:探讨右心房容积指数(RAVI)、T波峰-末间期(Tp-Te)与慢性收缩性心力衰竭(CSHF)患者预后的关系以及RAVI联合Tp-Te对CSHF患者预后的预测价值。方法:回顾性选择2020年1月至2021年7月山东大学附属威海市立医院心内科收治的172例CSHF患者的临床资料,采用超声心动图检测RAVI,心电图检测Tp-Te,根据随访1年期间患者预后情况分为预后不良组(84例)和预后良好组(88例)。采用多因素Logistic回归分析CSHF患者1年内预后不良的影响因素,受试者工作特征(ROC)曲线分析RAVI联合Tp-Te对CSHF患者预后不良的预测价值。结果:随访期间共84例发生预后不良,包括死亡23例、因急性心衰再次住院61例。预后不良组RAVI[(42.65±3.81)ml/m^(2)比(26.42±2.32)ml/m 2]、Tp-Te[(112.84±10.13)ms比(95.12±4.52)ms]显著高于预后良好组(P均<0.001)。Pearson相关分析显示RAVI、Tp-Te与左室射血分数(LVEF)呈负相关(r=-0.619、-0.537,P均<0.001),与左心室收缩末期容积(LVESV)、左心室舒张末期容积(LVEDV)、N端脑钠肽前体(NT-proBNP)均呈正相关(r=0.512~0.564,P均<0.001)。多因素Logistic回归分析显示,NT-proBNP(OR=1.865,95%CI 1.127~3.086,P=0.002)、RAVI(OR=1.697,95%CI 1.204~2.392,P<0.001)、Tp-Te(OR=1.640,95%CI 1.208~2.227,P<0.001)是CSHF患者1年内预后不良的独立危险因素。ROC分析显示,联合RAVI和Tp-Te预测CSHF患者1年内预后不良的曲线下面积(AUC)为0.949(95%CI 0.905~0.977),显著高于RAVI(0.788,95%CI 0.719~0.846)、Tp-Te(0.840,95%CI 0.777~0.892)单独预测(Z=4.435、3.856,P均<0.001)。结论:RAVI和Tp-Te增高是CSHF患者预后不良的危险因素,联合RAVI和Tp-Te在CSHF患者预后预测方面有较高价值。Objective:To investigate the association of right atrial volume index(RAVI),T-wave peak to end interval(Tp-Te)with prognosis of patients with chronic systolic heart failure(CSHF),and the predictive value of RAVI combined with Tp-Te for prognosis in these patients.Methods:The clinical data of 172 CSHF patients admitted in Department of Cardiovascular Medicine,Weihai Municipal Hospital,Cheeloo College of Medicine,Shandong University between January 2020 and July 2021 were retrospectively enrolled.RAVI and Tp-Te was measured by echocardiography and ECG respectively.According to prognosis within 1-year follow-up,they were divided into unfavorable outcome group(n=84)and favorable outcome group(n=88).Multivariate Logistic regression was employed to analyze influencing factors for unfavorable outcome within 1-year in CSHF patients,and receiver operating characteristic(ROC)curve was applied to analyze predictive value of RAVI combined Tp-Te for unfavorable outcome in CSHF patients.Results:During the follow-up,84 cases suffered from unfavorable outcomes,including 23 cases of death,61 cases of rehospitalization due to acute heart failure.RAVI[(42.65±3.81)ml/m^(2) vs.(26.42±2.32)ml/m 2]and Tp-Te[(112.84±10.13)ms vs.(95.12±4.52)ms]in unfavorable outcome group were significantly higher than those of favorable outcome group(P<0.001 all).Pearson correlation analysis indicated that RAVI,Tp-Te were inversely correlated with left ventricular ejection fraction(LVEF)(r=-0.619,-0.537,P<0.001 all),and positively correlated with left ventricular end-systolic volume(LVESV),left ventricular end-diastolic volume(LVEDV)and N-terminal pro brain natriuretic peptide(NT-proBNP)(r=0.512~0.564,P<0.001 all).Multivariate Logistic regression analysis indicated that NT-proBNP(OR=1.865,95%CI 1.127~3.086,P=0.002),RAVI(OR=1.697,95%CI 1.204~2.392,P<0.001)and Tp-Te(OR=1.640,95%CI 1.208~2.227,P<0.001)were independent risk factors for unfavorable outcome within 1-year in CSHF patients.ROC analysis found that RAVI combined Tp-Te predicting unfavorable o

关 键 词：心力衰竭 收缩性 心电描记术 超声心动描记术 预后 

分 类 号：R541.61[医药卫生—心血管疾病]