高龄女性射血分数保留的心力衰竭患者相关危险因素分析

Analysis of related risk factors in elderly women with HFpEF

目的探究高龄女性射血分数保留的心力衰竭(HFpEF)患者的临床特点及其影响因素。方法连续入选2017年1月至2020年12月就诊于北京中医药大学东直门医院心血管科年龄≥80岁的女性心力衰竭患者292例,根据LVEF分为射血分数减低的心力衰竭(HFrEF)组87例HFpEF组205例。比较2组临床资料,采用多因素logistic回归分析。结果HFpEF组心房颤动比例、血钾和LVEF明显高于HFrEF组,高脂血症、心肌梗死病史、冠心病血运重建比例及心率明显低于HFrEF组(P<0.05,P<0.01)。多因素logistic回归分析显示,心率(95%CI:1.008~1.056,P=0.009)、心肌梗死病史(95%CI:2.718~9.950,P=0.000)、冠心病血运重建(95%CI:1.042~3.648,P=0.037)、高脂血症(95%CI:1.615~6.068,P=0.001)是心力衰竭发作的独立危险因素。结论心肌梗死病史、高脂血症、冠心病血运重建术、心率是高龄女性心力衰竭的危险因素。

Objective To explore the clinical characteristics and influencing factors in elderly women with HFpEF.Methods Two hundred and ninety-two female patients with heart failure aged over 80 years who visited to the outpatient department of cardiovascular diseases of Dongzhimen Hospital from January 2017 to December 2020 were enrolled in this study.They were divided into HFrEF group(n=87)and HFpEF group(n=205)according to LVEF.The clinical data was compared between the 2 groups.Multivariate logistic regression analysis was used to analyze the related risk factors.Results The HFpEF group had significantly larger proportion of atrial fibrillation and higher potassium level and LVEF level,and lower heart rate and smaller proportions of hyperlipidemia,myocardial infarction history and coronary revascularization when compared with the HFrEF group(P<0.05,P<0.01).Multivariate logistic regression analysis showed that heart rate(95%CI:1.008-1.056,P=0.009),history of myocardial infarction(95%CI:2.718-9.950,P=0.000),coronary heart disease revascularization(95%CI:1.042-3.648,P=0.037)and hyperlipidemia(95%CI:1.615-6.068,P=0.001)were independent risk factors for HF.Conclusion The history of myocardial infarction,hyperlipidemia,coronary heart disease revascularization and heart rate are the risk factors for HF in elderly women patients.