衰弱对射血分数正常老年心力衰竭患者心脏功能及心功能相关生化指标水平的影响

Effects of weakness on cardiac function and levels of cardiac function-related biochemical indexes in elderly patients of heart failure with normal ejection fraction

目的探究衰弱对射血分数正常的老年心力衰竭(HFNEF)患者心脏功能及心功能相关生化指标水平的影响。方法选取2019年1月至2020年1月陆军军医大学第一附属医院收治的老年心力衰竭(HF)患者127例,根据衰弱诊断情况将患者分为衰弱组(54例)与非衰弱组(73例),比较两组患者的一般资料、心功能指标、心功能生化指标和心脏不良事件发生情况。结果两组患者性别、年龄差异无统计学意义(P>0.05),非衰弱组的体质指数和基础性疾病(高血压、糖尿病、心房颤动、冠心病)发病情况均高于衰弱组(P<0.05),两组患者心功能分级情况比较,差异有统计学意义(P<0.05);衰弱组患者的左室射血分数(LVEF)、左室舒张末期内径(LVEDD)和舒张早期血流最大充盈速度(VE)/舒张晚期最大充盈速度(VA)水平低于非衰弱组,室间隔厚度高于非衰弱组(P<0.05);衰弱组患者的BNP、NT-proBNP和hsCRP水平均高于非衰弱组(P<0.05);衰弱组的心脏不良事件总发生率衰弱组为29.63%(16例/54例)高于非衰弱组的10.96%(8例/73例),差异有统计学意义(P<0.05)。结论对比非衰弱HFNEF患者,衰弱HFNEF患者有更高的基础疾病发生率,衰弱会影响HFNEF患者的心脏舒张功能,增加心脏不良事件的发生。

Objective To explore effects of weakness on cardiac function and levels of cardiac function-related biochemical indexes in elderly patients of heart failure with normal ejection fraction(HFNEF).Methods During the period from January 2019 to January 2020,127 elderly patients with heart failure(HF)who were admitted to the hospital were enrolled.According to weakness diagnosis conditions,they were divided into weakness group(54 cases)and non-weakness group(73 cases).The general data,cardiac function indexes,cardiac function biochemical indexes and occurrence of adverse cardiac events were compared between the two groups.Results There was no significant difference in gender or age between the two groups(P>0.05).BMI and incidence of underlying diseases(hypertension,diabetes,atrial fibrillation,coronary heart disease)in non-weakness group were higher than those in weakness group(P<0.05).There were no significant differences in cardiac function grading between the two groups(P<0.05).The levels of LVEF,LVEDD and VE/VA in weakness group were lower than those in non-weakness group,while IVST level was higher than that in non-weakness group(P<0.05).The levels of BNP,NT-proBNP and hsCRP in weakness group were higher than those in non-weakness group(P<0.05).The total incidence of adverse cardiac events in weakness group was higher than that in non-weakness group[29.63%(16/54)vs.10.96%(8/73),P<0.05].Conclusion Compared with non-weakness HFNEF patients,incidence of underlying diseases is higher in patients with weakness HFNEF.Weakness will influence cardiac diastolic function of HFNEF patients,and increase the occurrence of adverse cardiac events.