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Eur J Heart Fail:射血分数与死亡率的关系

2020-11-25 MedSci原创 MedSci原创

在疑似或明确心血管疾病的患者中,与LVEF低于65.0-69.9%相关的分布和死亡率存在性别差异。具体而言,对于较高LVEF的女性死亡风险更高。

近日,血管领域权威杂志European Journal of Heart Failure上发表了一篇研究文章,研究人员通过对澳大利亚一大型患者队列旨在调查不同左室射血分数(LVEF)的个体基于性别的死亡风险。

首次接受常规超声心动图检查(2000-2019年)的237046名(48.1%)女性和256109名男性的LVEF数据与119232例死亡病例的数据(中位随访5.6年)相链接。

总体而言,LVEF<50%的男性为17.6%,女性为8.3%。LVEF<40%与5年最高的心血管相关死亡和全因死亡相关;分别为〜20-30%和〜40-50%。此后,男性和女性在5年时的实际心血管相关死亡率和全因死亡率急剧上升,LVEF为65.0-69.9%时最低(参考组)。低于此LVEF水平时,女性LVEF为55.0-59.9%时经调整的心血管相关死亡风险比(HR)为1.36(95%CI为1.16,1.59;p<0.001),男性为1.21(95%CI为1.05,1.39);p=0.008)。在女性中,对于心血管相关死亡率,LVEF为60.0-64.9%也其相关,对应HR为1.33(95%CI为1.16,1.52;p<0.001)。这些关联最显著的是65岁以下的男女,并在有疑似心衰的患者中重复出现(32403例,年龄为65.2±16.1岁,女性为57.0%)。对于既往有心力衰竭(33738例,年龄为67.6±16.9岁,女性为46.5%),死亡率增加的特定阈值为50.0-54.9%或以下。

由此可见,在疑似或明确心血管疾病的患者中,与LVEF低于65.0-69.9%相关的分布和死亡率存在性别差异。具体而言,对于较高LVEF的女性死亡风险更高。

原始出处:

Simon Stewart.et al.Ejection Fraction and Mortality: A Nationwide Register Based Cohort Study of 499,153 Women and Men.European journal of heart failure.2020.https://onlinelibrary.wiley.com/doi/10.1002/ejhf.2047

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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=902543, encodeId=c19890254320, content=所以要尽可能将LVE F保持在65%以上<a href='/topic/show?id=974e51e2810' target=_blank style='color:#2F92EE;'>#心血管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=152, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51728, encryptionId=974e51e2810, topicName=心血管)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210607/9f00a0de660e4b36b77a9a5f7620d6bf/98c22b17ddf7446fa7b9a618fabcb9f7.jpg, createdBy=a8fb2299762, createdName=Psycho.Dr Du, createdTime=Thu Nov 26 17:07:08 CST 2020, time=2020-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=902469, encodeId=b52c902469f9, content=👍🏻, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, 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CST 2020, time=2020-11-25, status=1, ipAttribution=)]
    2020-12-09 ms9000001331139782

    如何将LVEF保持在65%以上呢

    0

  2. 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    2020-11-27 咻凡

    在疑似或明确心血管疾病的患者中,与LVEF低于65.0-69.9%相关的分布和死亡率存在性别差异。具体而言,对于较高LVEF的女性死亡风险更高。

    0

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CST 2020, time=2020-11-25, status=1, ipAttribution=)]
    2020-11-27 zhaojie88
  4. 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=902543, encodeId=c19890254320, content=所以要尽可能将LVE F保持在65%以上<a href='/topic/show?id=974e51e2810' target=_blank style='color:#2F92EE;'>#心血管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=152, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51728, encryptionId=974e51e2810, topicName=心血管)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210607/9f00a0de660e4b36b77a9a5f7620d6bf/98c22b17ddf7446fa7b9a618fabcb9f7.jpg, createdBy=a8fb2299762, createdName=Psycho.Dr Du, createdTime=Thu Nov 26 17:07:08 CST 2020, time=2020-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=902469, encodeId=b52c902469f9, content=👍🏻, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, 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authenticateStatus=null, createdAvatar=null, createdBy=18555434658, createdName=ms7000000409152408, createdTime=Wed Nov 25 23:52:36 CST 2020, time=2020-11-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=902300, encodeId=bf8a9023003c, content=👍, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=a01d5438507, createdName=ms5000001813006281, createdTime=Wed Nov 25 21:53:11 CST 2020, time=2020-11-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=902299, encodeId=c0089022994e, content=👍, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=091b5438470, createdName=ms4000000157588459, createdTime=Wed Nov 25 21:52:04 CST 2020, time=2020-11-25, status=1, ipAttribution=)]
    2020-11-27 slcumt
  5. 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CST 2020, time=2020-11-25, status=1, ipAttribution=)]
    2020-11-26 Psycho.Dr Du

    所以要尽可能将LVE F保持在65%以上#心血管#

    0

  6. 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CST 2020, time=2020-11-25, status=1, ipAttribution=)]
    2020-11-26 无需言语

    👍🏻

    0

  7. 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    2020-11-26 飞翔的乌龟

    👍👍👍👍

    0

  8. 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=902543, encodeId=c19890254320, content=所以要尽可能将LVE F保持在65%以上<a href='/topic/show?id=974e51e2810' target=_blank style='color:#2F92EE;'>#心血管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=152, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51728, encryptionId=974e51e2810, topicName=心血管)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210607/9f00a0de660e4b36b77a9a5f7620d6bf/98c22b17ddf7446fa7b9a618fabcb9f7.jpg, createdBy=a8fb2299762, createdName=Psycho.Dr Du, createdTime=Thu Nov 26 17:07:08 CST 2020, time=2020-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=902469, encodeId=b52c902469f9, content=👍🏻, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, 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    2020-11-25 ms7000000409152408

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  9. 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    2020-11-25 ms5000001813006281

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  10. 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    2020-11-25 ms4000000157588459

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