JACC: Heart Failure:独辟蹊径!JACC称评估心衰病情可用18米步行试验:超过31秒风险增加

2017-06-09 许菁 中国循环杂志

俄亥俄州立大学学者近日在JACC上发表文章提出一个用于评估心衰患者心功能的新的运动试验——60英尺(约18米)步行试验。该方法实施起来要比6分钟步行时间更加简单、易行。

俄亥俄州立大学学者近日在JACC上发表文章提出一个用于评估心衰患者心功能的新的运动试验——60英尺(约18米)步行试验。该方法实施起来要比6分钟步行时间更加简单、易行。

60英尺步行试验是在医院走廊里标记一个15英尺的距离,告知患者在尽可能短的时间内走4趟,要求患者采用舒适的步伐完成实验,不能跑。坚持走直线,抵达终点时以最小的弯度转弯。用秒表记录患者走完15英尺所用的时间,整个过程,检测者不能干预患者。

研究者称,60英尺步行试验弥补6分钟步行试验的不足,可替代6分钟步行试验用于评估心衰患者的病情。

本研究中,144例心衰患者走60英尺的中位时间为26秒。患者的60英尺步行时间越长,则6分钟步行距离越短,心衰症状越严重性。60英尺步行时间延长预示3个月内的心衰症状加重。

60英尺步行时间超过31秒即预示着心衰住院及死亡风险增加。患者的60英尺步行时间长达31秒,则心衰住院和死亡风险增加1倍多。

60英尺步行时间每增加1秒,则心衰住院及死亡风险增加4%。

60英尺步行时间用于评估心衰病情与6分钟步行试验的结果高度一致。

另外,一些症状严重无法完成6分钟步行实验的心衰患者反而会尝试接受60英尺步行试验。

研究者指出,60英尺步行时间也可用于外周动脉疾病、慢性阻塞性肺病和肺动脉高压的病情评估。

原始出处:

Kristie M. Harris, David S. Krantz, Willem J. Kop, et al. A New Clinically Applicable Measure of Functional Status in Patients With Heart Failure: The 60-Foot Walk Test. JACC: Heart Failure, 2017, 5:00-00.

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    2021-09-15 湘雅科教

    值得学习

    0

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    2017-12-16 hbwxf
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    2017-10-26 docwu2019
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    2018-05-05 yuanming15
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    2017-06-11 zhaojie88
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    2017-06-11 slcumt

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在许多国家,心血管疾病已经成为死亡率最高的“第一大杀手”了,而心血管疾病“走入末路”时导致的就是心力衰竭,尽管一些治疗心衰的药物已经被广泛使用,但是心力衰竭的患者在初次诊断后5年内的死亡率仍然高达40%(1)!

JACC:心衰患者给予β-受体阻滞剂很大耐受剂量 还有改善的空间吗?

心衰(HF)患者给予β-受体阻滞剂最大耐受剂量,其还有改善的空间吗?2017年5月,发表在《J Am Coll Cardiol》的一项综述总结了发表的β-受体阻滞剂改善临床结局的机制的报告,描述了里程碑式临床试验和常规临床实践中β-受体阻滞剂剂量的差异,进一步探讨了不耐受的理由以及β-受体阻滞剂的使用剂量和作为治疗目标的心率背后的证据。

SCI REP:左心室血流动力作为左束支传导阻滞心力衰竭患者的机械不同步的一个标志!

由此可见,机械不同步的这种独特的流量特异性指标可以作为一个额外的工具,考虑到心衰患者传导异常的风险,并且被证实在预测对CRT的反应上也是有用的。

Circulation:Traf2通过抑制细胞程序性坏死在治疗心衰和心脏病理重塑中起到重要作用!

程序性细胞死亡,包括细胞凋亡、线粒体介导的细胞坏死和程序性坏死,在缺血性心脏损伤、病理性心脏重塑和心力衰竭的进展中起到关键作用。尽管细胞凋亡和线粒体介导的坏死信号传导已经比较明确,但人心脏程序性坏死的调节机制及其在心力衰竭发病机制中的意义尚远未阐明。

JAHA:白细胞介素13受体α1在心肌稳态和心力衰竭中的新作用!

由此可见,在人类和小鼠的研究结果首次表明白细胞介素13受体α1在心肌稳态和心力衰竭中的作用,这为心脏病的治疗提供了新的治疗靶点。