相位角水平与射血分数降低的心力衰竭患者预后的相关性研究

Correlation between phase angle and prognosis in patients with heart failure and reduced ejection fraction

目的分析射血分数降低的心力衰竭(HFrEF)患者生物电阻抗指标相位角与预后的相关性。方法连续纳入重庆市开州区人民医院心内科住院治疗的HFrEF患者98例,收集相关临床资料,并随访1年。随访终点为心血管疾病相关的死亡和因心力衰竭加重导致的再入院。通过受试者工作特征(ROC)曲线选取相位角判断预后的最佳截断值,采用Cox比例风险回归模型探讨相位角对HFrEF终点事件的预测能力并绘制患者预后的生存曲线。结果相位角判断HFrEF患者预后的最佳截断值为4.2°(灵敏度为0.78,特异度为0.81,曲线下面积为0.76,P<0.05)。与相位角≥4.2°的患者相比,相位角<4.2°的HFrEF患者随访1年的死亡和再入院风险增加2.41倍(风险比:2.41,95%CI:1.85~3.18,P<0.05)。结论较低水平的相位角与HFrEF患者的再入院率和心血管相关的病死率显著相关,常规监测该类患者的相位角水平有助于判断其预后。

Objective To analyze the correlation between the bioelectricity impedence index phase angle and prognosis in the patients with heart failure and reduced ejection fraction(HFrEF).Methods A total of continuous 98 inpatients with HFrEF in kaizhou District People′s Hospital were included.The related clinical data were collected and 1-year follow up was conducted.The follow up endpoint was the cardiovascular disease related death and re-hospitalization due to aggravation of heart failure.The phase angle was selected by the receiver operation characteristic(ROC)curve for judging the best cut-off value of prognosis.The multivariate Cox proportional risk regression model was adopted to investigate the predictive ability of the phase angle to the endpoint events and draw the survival curve of patient′s prognosis.Results The best cut-off value of phase angle for judging the prognosis in HFrEF patients was 4.2°(the sensitivity 0.78,specificity 0.81,area under the curve 0.76,P<0.05).Compared with the patients with phase angle≥4.2°,the risk of death and re-hospitalization during 1-year follow up in the patients with phase angle<4.2°was increased by 2.41 folds(hazard ratio:2.41,95%CI:1.85-3.18,P<0.05).Conclusion The lower level phase angle is closely correlated with the re-hospitalization and cardiovascular disease related fatality rate in the patients with HFrEF.The routine monitoring the phase angle level in this kind of patients is conducive to judge their prognosis.