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Circulation：射血分数保留型心衰收缩功能受损的预后（TOPCAT研究）

2015-07-06 MedSci译 MedSci原创

射血分数保留型心衰
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    左心室（LV）收缩功能障碍已结合射血分数保留型心衰（HFpEF）进行了了说明，但其预后的相关性是未知的。研究人员确定了是否LV纵向应变（LS）可以预测的心血管（CV）在临床之外的HFPEF成果和常规超声心动图的措施。    在一项用醛固酮拮抗剂治疗保留性心衰的（TOPCAT）试验中，447例HFpEF患者参与了此项研究，其中LS是在基线由二维斑点跟踪

左心室（LV）收缩功能障碍已结合射血分数保留型心衰（HFpEF）进行了了说明，但其预后的相关性是未知的。研究人员确定了是否LV纵向应变（LS）可以预测的心血管（CV）在临床之外的HFPEF成果和常规超声心动图的措施。

在一项用醛固酮拮抗剂治疗保留性心衰的（TOPCAT）试验中，447例HFpEF患者参与了此项研究，其中LS是在基线由二维斑点跟踪超声心动图评估的。在平均随访2.6（IQR 1.5-3.9）年时，115例患者发生主要复合终点为心血管死亡，心衰住院，或中止心脏骤停事件。LS受损，被定义为绝对LS<15.8％，存在于52％的患者中，是复合终点的预测（调整后的HR 2.14，95％Cl 1.26-3.66；P= 0.005），调整临床和超声心动图的常规变量后，，仅CV死亡（调整后的HR 3.20，95％Cl 1.44-7.12；P=0.004），仅HF住院（调整后的HR 2.23，95％Cl 1.16-4.28；P=0.016）。LS是复合终点的最强超声心动图的预测。在一个131例子集探索性分析中，12-18个月后随访LS评估表明，通过螺内酯可以改善LS的是来自于美国的患者，而不是俄罗斯或格鲁吉亚的患者。

LV收缩功能受损是HFpEF心衰住院，心血管死亡，或心脏骤停的一个强大的预测，独立于临床预测。LS受损代表了一种新的生物标志物成像可以来识别HFpEF患者尤其是在高风险情况下的心血管发病率和死亡率。

原始出处：
Amil M. Shah1*; Brian Claggett1; Nancy K. Sweitzer2; Sanjiv J. Shah3; Inder S. Anand4; Li Liu1; Bertram Pitt5; Marc A. Pfeffer1; Scott D. Solomon1,The Prognostic Importance of Impaired Systolic Function in Heart Failure with Preserved Ejection Fraction and the Impact of Spironolacton,Circulation,2015.6.30

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    2016-03-08 lixiao3338

    #射血分数保留#

    0

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    2016-02-26 bluefate121

    #射血分数保留型心衰#

    0

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    2016-03-13 guguangxiang

    #OPCA#

    0

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    2015-07-26 Keren1970

    学习

    0

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    2015-07-14 保守主义

    又学习一次

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1746302, encodeId=11fe1e4630225, content=<a href='/topic/show?id=699a46801f4' target=_blank style='color:#2F92EE;'>#射血分数保留#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46801, encryptionId=699a46801f4, topicName=射血分数保留)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c84e35706999, createdName=lixiao3338, createdTime=Tue Mar 08 02:29:00 CST 2016, time=2016-03-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2031966, encodeId=0070203196606, content=<a href='/topic/show?id=3c834680239' target=_blank style='color:#2F92EE;'>#射血分数保留型心衰#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46802, encryptionId=3c834680239, topicName=射血分数保留型心衰)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93e223, createdName=bluefate121, createdTime=Fri Feb 26 16:29:00 CST 2016, time=2016-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1987734, encodeId=2fe1198e734e6, content=<a href='/topic/show?id=ae001340263' target=_blank style='color:#2F92EE;'>#OPCA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13402, encryptionId=ae001340263, topicName=OPCA)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/iaP1mV9qBwx5tE2F4xcG1r4x1PibWvluIFLB8VsViakqNMBia2Z0wFibVrYwDEILvHB1OomzzTAAGy5MVl5BrdEv9Bw/132, createdBy=e11f100, createdName=guguangxiang, createdTime=Sun Mar 13 14:29:00 CST 2016, time=2016-03-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=33493, encodeId=de9033493c8, content=学习 <br> , beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9daf1619121, createdName=Keren1970, createdTime=Sun Jul 26 07:24:00 CST 2015, time=2015-07-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=32695, encodeId=5ff1326951b, content=又学习一次, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d0f31631005, createdName=保守主义, createdTime=Tue Jul 14 07:17:00 CST 2015, time=2015-07-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=31610, encodeId=0d2f31610f6, content=看看, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ee0d1618732, createdName=huaxipanxing, createdTime=Wed Jul 08 12:22:00 CST 2015, time=2015-07-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=31426, encodeId=d54b314265f, content=有意思, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200609/ef6a57dbe7f1489dad7446b7c5217858/d5e4fe65996c4446a029b0f5d056abb1.jpg, createdBy=6b011518214, createdName=午夜星河, createdTime=Tue Jul 07 13:41:00 CST 2015, time=2015-07-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=30965, encodeId=d251309654d, content=可借鉴, beContent=null, objectType=article, channel=null, level=null, likeNumber=133, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d0f31631005, createdName=保守主义, createdTime=Tue Jul 07 07:06:00 CST 2015, time=2015-07-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=30951, encodeId=77aa3095132, content=真好，学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e880105337, createdName=famous, createdTime=Tue Jul 07 06:35:00 CST 2015, time=2015-07-07, status=1, ipAttribution=)]
    2015-07-08 huaxipanxing

    看看

    0

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    2015-07-07 午夜星河

    有意思

    0

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    2015-07-07 保守主义

    可借鉴

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1746302, encodeId=11fe1e4630225, content=<a href='/topic/show?id=699a46801f4' target=_blank style='color:#2F92EE;'>#射血分数保留#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46801, encryptionId=699a46801f4, topicName=射血分数保留)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c84e35706999, createdName=lixiao3338, createdTime=Tue Mar 08 02:29:00 CST 2016, time=2016-03-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2031966, encodeId=0070203196606, content=<a href='/topic/show?id=3c834680239' target=_blank style='color:#2F92EE;'>#射血分数保留型心衰#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46802, encryptionId=3c834680239, topicName=射血分数保留型心衰)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93e223, createdName=bluefate121, createdTime=Fri Feb 26 16:29:00 CST 2016, time=2016-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1987734, encodeId=2fe1198e734e6, content=<a href='/topic/show?id=ae001340263' target=_blank style='color:#2F92EE;'>#OPCA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13402, encryptionId=ae001340263, topicName=OPCA)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/iaP1mV9qBwx5tE2F4xcG1r4x1PibWvluIFLB8VsViakqNMBia2Z0wFibVrYwDEILvHB1OomzzTAAGy5MVl5BrdEv9Bw/132, createdBy=e11f100, createdName=guguangxiang, createdTime=Sun Mar 13 14:29:00 CST 2016, time=2016-03-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=33493, encodeId=de9033493c8, content=学习 <br> , beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9daf1619121, createdName=Keren1970, createdTime=Sun Jul 26 07:24:00 CST 2015, time=2015-07-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=32695, encodeId=5ff1326951b, content=又学习一次, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d0f31631005, createdName=保守主义, createdTime=Tue Jul 14 07:17:00 CST 2015, time=2015-07-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=31610, encodeId=0d2f31610f6, content=看看, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ee0d1618732, createdName=huaxipanxing, createdTime=Wed Jul 08 12:22:00 CST 2015, time=2015-07-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=31426, encodeId=d54b314265f, content=有意思, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200609/ef6a57dbe7f1489dad7446b7c5217858/d5e4fe65996c4446a029b0f5d056abb1.jpg, createdBy=6b011518214, createdName=午夜星河, createdTime=Tue Jul 07 13:41:00 CST 2015, time=2015-07-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=30965, encodeId=d251309654d, content=可借鉴, beContent=null, objectType=article, channel=null, level=null, likeNumber=133, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d0f31631005, createdName=保守主义, createdTime=Tue Jul 07 07:06:00 CST 2015, time=2015-07-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=30951, encodeId=77aa3095132, content=真好，学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e880105337, createdName=famous, createdTime=Tue Jul 07 06:35:00 CST 2015, time=2015-07-07, status=1, ipAttribution=)]
    2015-07-07 famous

    真好，学习了

    0