中国不同射血分数亚型心力衰竭住院患者临床特征分析

Clinical characteristics of hospitalized heart failure patients with different ejection fraction in China

目的比较中国慢性心力衰竭(心衰,HF)患者3种不同左心室射血分数(LVEF)亚型的临床特征。方法基于中国住院患者心力衰竭(CN-HF)注册研究(NCT02079428)入组患者数据,根据LVEF将患者分为3组:LVEF降低(≤40%)组(HFrEF组)、LVEF轻度降低(41%~49%)组(HFmrEF组),以及LVEF保留(≥50%)组(HFpEF组)。比较各组患者的临床特征。结果共纳入5605例住院心衰患者,男性占59.9%,平均年龄(69.5±13.5)岁。与HFrEF组(n=2068)相比,HFpEF组(n=2941)女性较多(48.5%vs 29.1%),且年龄[(71.1±12.9)岁vs(66.9±13.9)岁]较大,纽约心脏病协会(NYHA)心功能分级Ⅲ~Ⅳ患者较少(43.3%vs 73.7%),高血压更常见(74.3%vs 64.3%)。3组间性别、年龄、心功能分级及高血压发生率差异均有统计学意义(P<0.0001)。所有患者3年全因死亡率为20.7%,HFrEF组、HFmrEF组和HFpEF组患者依次为26.4%、21.6和16.5%(Z=8.5074;P<0.001)。结论与HFrEF患者相比,我国住院的HFpEF患者年龄大、女性多见、合并症发生率较高,但3年随访期间预后相对较好。

Objective To investigate the clinical characteristics among three different left ventricular ejection fraction(LVEF)subtypes of patients with chronic heart failure(HF)in China.Methods The data were from China National Heart Failure(CN-HF)registry(NCT02079428).Patients were categorized into three groups based on their LVEF:HF with reduced ejection fraction(≤40%)group(HFrEF group),HF with mildly reduced ejection fraction(41%-49%)group(HFmrEF group),and HF with preserved ejection fraction(≥50%)group(HFpEF group).Basic characteristics in each group were analyzed and compared.Results A total of 5605 hospitalized patients with HF were enrolled in this real world registry study(mean age was[69.5±13.5]years old,59.9%were male).Compared to HFrEF group(n=2068),HFpEF group(n=2941)had more females(48.5%vs 29.1%)and patients were older[(71.1±12.9)]years old vs[66.9±13.9]years old),with less New York Heart Assocation(NYHA)Ⅲ-Ⅳones(43.3%vs 73.7%),and more hypertension patients(74.3%vs 64.3%).There were significant difference among the three groups in gender,age,NYHA grade and hypertension rate(P<0.0001).The 3-year all-cause mortality rate was 20.7%in all patients,26.4%,21.6,and 16.5%in HFrEF,HFmrEF,and HFpEF patients,respectively(Z=8.5074,P<0.001).Conclusions Compared with HFrEF patients,HFpEF patients are older,more often women,and have a higher prevalence of comorbidities,and have a relatively favorable prognosis during 3 year follow-up.