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|本期目录/Table of Contents|

中老年人颈动脉硬化与左室射血分数正常的心力衰竭的关联性

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2015年第5期
页码:
592-595
栏目:
临床研究
出版日期:
2015-05-05

文章信息/Info

Title:
Association of carotid atherosclerosis and heart failure with normal left ventricular ejection fraction in middle-aged and elderly population
作者:
任 飞; 梁冬科; 余陆娇; 王春雷
(中国医科大学附属第一医院老年病科，辽宁 沈阳 110001)
Author(s):
REN Fei;  LIANG Dong-ke;  YU Lu-jiao;  WANG Chun-lei
(Department of Geriatrics, First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning, China)
关键词:
心力衰竭; 左室射血分数; 颈动脉硬化; 左心室质量指数; 心肌重构
Keywords:
heart failure;  normal left ventricular ejection fraction;  carotid atherosclerosis;  left ventricular mass index
分类号:
R541.6
DOI:
-
文献标识码:
A
摘要:
目的 研究中老年患者颈动脉硬化与左室射血分数(LVEF)正常的心力衰竭(HFNEF)的关联性，并探讨中老年患者HFNEF早期预测因素。方法 收集在我院住院的有心衰高危因素的中老年患者344名，按有无HFNEF分为2组:HFNEF组和无心功能异常组(NHF)，对两组患者一般临床资料、血脂、脑钠尿肽(BNP)、血肌酐、肾小球滤过率(GFR)、LVEF、颈动脉硬化、颈动脉斑块积分、左心室质量指数(LVMI)等进行单因素分析及多因素logistic回归分析。结果 logistic回归分析显示HFNEF独立相关的因素有颈动脉硬化、糖尿病、LVMI，GFR，其中颈动脉硬化、糖尿病、LVMI为独立危险因素（OR值分别为3.46、2.45和1.08，均P<0.01），而GFR是保护因素（OR值0.98，P<0.05）。结论 颈动脉硬化是中老年HFNEF的独立危险因素。
Abstract:
AIMTo study the association of carotid atherosclerosis and heart failure with normal left ventricular ejection fraction (HFNEF) in middle-aged and elderly populations and discuss early predictors of HFNEF. METHODSA total of 344 middle-aged and elderly in-patients ［mean age (62±9) years］ were divided into two groups: HFNEF group or normal heart function (NHF) group whose clinical data were collected such as general condition, medical history, serum lipid, BNP, serum creatinine, GFR, LVEF, carotid atherosclerosis, carotid plaque, Crouse score, LVMI, etc. Univariate analysis and logistic regressive analysis were carried out. RESULTSLogistic regressive analysis of HFNEF showed that after adjusting for other factors, carotid atherosclerosis (OR 3.46, P<0.01), diabetes mellitus (DM, OR 2.45, P<0.01), LVMI (OR 1.08, P<0.01) were independent risk factors for HFNEF and the most significant predictor of HFNEF is carotid atherosclerosis. CONCLUSIONThis study showed HFNEF is associated with carotid atherosclerosis. Carotid atherosclerosis is a significant risk predictor of HFNEF in middle-aged and elderly patients.

参考文献/References

[1]中华医学会心血管病学分会,中华心血管病杂志编辑委员会.中国心力衰竭诊断和治疗指南2014[J].中华心血管病杂志,2014,42(2):98-122.
[2]Bernard S,Maurer MS.Heart Failure with a Normal Ejection Fraction:Treatments for aComplex Syndrome?[J].Curr Treat Options Cardiovasc Med,2012,14(4):305-318.
[3]Lorenz MW,Markus HS,Bots ML,et al.Prediction of clinical cardiovascular events with carotid intima-media thickness:a systematic review and meta-analysis[J].Circulation,2007,115(4):459-467.
[4]Paulus WJ,Tsch?pe C,Sanderson JE,et al.How to diagnose diastolic heart failure: a consensus statement on the diagnosis of heart failure with normal left ventricular ejection fraction by the Heart Failure and Echocardiography Associations of the European Society of Cardiology[J].Eur Heart J,2007,28(20):2539-2550.
[5]穆 洋,徐 勇,智 光,等.颈动脉斑块评分与冠状动脉粥样硬化严重程度的相关性[J].中华医学杂志,2013,93(24):1891-1893.
[6]Garg N,Senthilkumar A,Nusair MB,et al.Heart Failure with a Normal Left Ventricular Ejection Fraction: Epidemiology, Pathophysiology, Diagnosis and Management[J].Am J Med Sci,2013,346(2):129-136.
[7]Borlaug BA.The Pathophysiology of Heart Failure With Preserved Ejection Fraction[J].Nat Rev Cardiol,2014,11(9):507-515.
[8]Lukowicz TV,Fischer M,Hense HW,et al.BNP as a marker of diastolic dysfunction in the general population:Importance of left ventricular hypertrophy[J].Eur J Heart Fail,2005,7(4):525-531.
[9]Luchner A,Burnett JC Jr,Jougasaki M,et al.Evaluation of brain natriuretic peptide as marker of left ventricular dysfunction and hypertrophy in the population[J].J Hypertens,2000,18(8):1121-1128.
[10]Mizuno Y,Jacob RF,Mason RP.Inflammation and the development of atherosclerosis[J].J Atheroscler Thromb,2011,18(5):351-358.
[11]Lavi S,Bae JH,Rihal CS,et al.Segmental coronary endothelial dysfunction in patients with minimal atherosclerosis is associated with necrotic core plaques[J].Heart,2009,95(18):1525-1530.
[12]付明强,周京敏,胡 凯.糖尿病舒张性心功能不全的机制研究[J].心血管病学进展,2011,32(6):782-785.
[13]Leung M,Phan V,Leung DY.Endothelial function and left ventricular diastolic functional reserve in type 2 diabetes mellitus[J].Open Heart,2014,1(1):e000113.
[14]Roos CJ,Auger D,Djaberi R,et al.Relationship between left ventricular diastolic function and arterial stiffness in asymptomatic patients with diabetes mellitus[J].Int J Cardiovasc Imaging,2013,29(3):609-616.
[15]Deverux RB,Roman MJ,Parancias BA,et al.Impact of diabetes on cardiac structure and function strong heart study［J］. Circulation, 2000, 101(1):2271-2276.
[16]Powell BD, Redfield MM,Bybee KA.Association of obesity with left ventricular remodeling and diastolic dysfunction in patients without coronary artery disease[J].Am J Cardiol,2006,98(1):116-120.
[17]Westermann D,Kasner M,Steendijk P,et al.Role of left ventricular stiffness in heart failure with normal ejection fraction[J].Circulation,2008, 117(16):2051-2060.

备注/Memo

备注/Memo:
收稿日期: 2014-12-07.
通讯作者：王春雷，副主任医师，主要从事老年多器官功能衰竭研究 Email：wcl201010@163.com
作者简介：任飞，住院医师，硕士生 Email：56379907@qq.com
更新日期/Last Update: 2015-04-28