A&R:系统性硬化症的舒张功能障碍:危险因素和对死亡率的影响

2022-05-17 MedSci原创 MedSci原创

舒张功能障碍与系统性硬化症(SSc)患者死亡风险增加独立相关。应在SSc患者中解决潜在可改变的风险因素,包括冠状动脉疾病和肥胖以降低死亡风险。

    目的:系统性硬化症(SSc)中的原发性心脏受累占SSc相关死亡的三分之一,传统上包括传导阻滞、心律失常和非缺血性心肌病。该研究目的在于确定SSc患者舒张功能障碍(DD)的独立危险因素,并评估DD对死亡率的影响。

    方法:纳入2006111日至2017111日约翰霍普金斯硬皮病中心队列的SSc患者,在该研究团队的系统中具有≥1个可分析的二维(2-D)超声心动图(n=806)。前瞻性地获得了DD危险因素和SSc疾病特征,并使用最近的二维超声心动图确定是否存在DD逻辑回归模型检查了临床危险因素与DD之间的关联,并使用Cox比例风险模型来评估生存率。

    结果:18.6%SSc患者存在DD。大多数是女性(84%),中位年龄为58.4岁(四分位间距48.8-68.1)。年龄较大(优势比[OR] 1.12 [95%置信区间(95% CI) 1.09-1.15]P<0.001),冠状动脉疾病(OR 3.69 [95% CI 1.52-8.97]P=0.004),肥胖(OR 4.74 [95% CI 2.578.74]P<0.001),SSc病程更长(OR 1.04 [95% CI 1.011.06]P=0.004),一氧化碳扩散能力≤预测值的60%OR 2.41 [95% CI 1.404.16]P=0.002)和硬皮病肾危象病史(OR 3.18 [95% CI 1.129.07]P=0.031)均与DD风险增加独立相关。Scl-70 阳性(OR 0.49 [95% CI 0.26-0.93]P=0.03)和严重的胃肠道疾病(OR 0.48 [95% CI 0.30-0.79]P=0.004)与DD风险降低相关。DD的存在与死亡风险的增加独立相关(风险比 1.69 [95% CI 1.072.68]P=0.027)。

    结论:DDSSc患者死亡风险增加独立相关。应在SSc患者中解决潜在可改变的风险因素,包括冠状动脉疾病和肥胖,以降低死亡风险。 

出处:Hinze, A.M., Perin, J., Woods, A., Hummers, L.K., Wigley, F.M., Mukherjee, M. and Shah, A.A. (2022), Diastolic Dysfunction in Systemic Sclerosis: Risk Factors and Impact on Mortality. Arthritis Rheumatol, 74: 849-859. https://doi.org/10.1002/art.42054

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    2022-09-14 yahu
  5. [GetPortalCommentsPageByObjectIdResponse(id=1667204, encodeId=8db1166e20454, content=<a href='/topic/show?id=53158658854' target=_blank style='color:#2F92EE;'>#舒张功能障碍#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=86588, encryptionId=53158658854, topicName=舒张功能障碍)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=384626121720, createdName=10518102zz, createdTime=Wed Aug 03 00:05:22 CST 2022, time=2022-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2017365, encodeId=e520201e3651f, content=<a href='/topic/show?id=9760e69058c' target=_blank style='color:#2F92EE;'>#系统性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76905, encryptionId=9760e69058c, topicName=系统性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2b9b368, createdName=qingrejiedu, createdTime=Thu Dec 22 08:05:22 CST 2022, time=2022-12-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1983236, encodeId=ae3a1983236c3, content=<a href='/topic/show?id=a7a7e359478' target=_blank style='color:#2F92EE;'>#硬化症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73594, encryptionId=a7a7e359478, topicName=硬化症)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a691420, createdName=30397604, createdTime=Fri Dec 30 20:05:22 CST 2022, time=2022-12-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2026177, encodeId=cc5b20261e7b0, content=<a href='/topic/show?id=c2968658593' target=_blank style='color:#2F92EE;'>#舒张功能#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=86585, encryptionId=c2968658593, topicName=舒张功能)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=52c7237, createdName=yahu, createdTime=Wed Sep 14 17:05:22 CST 2022, time=2022-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1421444, encodeId=190414214449e, content=<a href='/topic/show?id=09d33294eb8' target=_blank style='color:#2F92EE;'>#功能障碍#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32947, encryptionId=09d33294eb8, topicName=功能障碍)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b3493649807, createdName=naiwu78, createdTime=Thu May 19 02:05:22 CST 2022, time=2022-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1627417, encodeId=546e162e4177c, content=<a href='/topic/show?id=dbcee69217e' target=_blank style='color:#2F92EE;'>#系统性硬化#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76921, encryptionId=dbcee69217e, topicName=系统性硬化)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8cf521117287, createdName=yhy100207, createdTime=Thu May 19 02:05:22 CST 2022, time=2022-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1220556, encodeId=9b75122055650, content=哈哈哈还好还好, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Ket8m6MIibXhvbjRGgD0H2QkkxMsABMZJJejJzbrE7vj81PFX7Ywct0bbjqz6QVK1y0xFGibylE59nWbjZddGNIg/132, createdBy=74df5244281, createdName=Chen chen1547, createdTime=Tue May 17 21:59:32 CST 2022, time=2022-05-17, status=1, ipAttribution=)]
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    2022-05-17 Chen chen1547

    哈哈哈还好还好

    0

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