心力衰竭患者血浆甲状旁腺素浓度与房颤发生相关性分析

目的:评估心力衰竭(HF)患者血浆甲状旁腺素(PTH)浓度与房颤(AF)发生的相关性。方法:研究对象为131例HF患者,根据医院心电图将患者分为心律正常组(n = 95)和AF组(n = 36)。比较两组患者基线及临床特征。采用逻辑回归分析确定AF的影响因素。采用ROC曲线分析确定PTH预测AF的最佳临界值。结果:AF患者血浆PTH浓度高于心律正常患者(P P P P Objective: To analyze the relationship between plasma parathyroid hormone (PTH) concentrations and atrial fibrillation (AF) in patients with heart failure (HF). Methods: A total of 131 patients with HF were enrolled in this study. According to the electrocardiogram, the patients were divided into normal rhythm group (n = 95) and AF group (n = 36). The baseline and clinical characteristics of the two groups were compared. Logistic regression analysis was used to determine the influencing factors of AF. ROC curve analysis was used to determine the optimal cut-off value of PTH for predicting AF. Results: The plasma PTH concentration was higher in AF patients than in normal rhythm patients (P P P P < 0.05). ROC curve analysis showed that the optimal cut-off value of PTH for the diagnosis of AF was ≥68.2 pg/ml, with a sensitivity of 44.2% and a specificity of 83.3%. Conclusion: There was a positive correlation between plasma PTH concentration and the occurrence of atrial fibrillation (AF) in HF patients.

心力衰竭伴房颤患者静息心率与死亡率的相关性分析

评估心力衰竭(HF)伴房颤(AF)患者出院时静息心率与死亡率之间的关系。方法 研究对象为144例急性HF患者。根据患者出院前静息心率将患者分为两组:高心率组(心率>81bpm)(n=50)和低心率组(心率≤81bpm)(n=94)。随访2年,观察两组患者死亡率。评估静息心率与死亡率的关系。结果在患者随访期间,41例患者(28.5%)死亡。与低心率组相比,高心率组患者死亡率更高(38.0%[19/50]vs 23.4%[22/94],P=0.049)。Cox比例风险分析显示,静息心率增高和老龄均为死亡风险相关因素(所有P<0.05);而服用β受体阻滞剂显著降低了死亡率(P<0.05)。结论 与出院低心率患者相比较,高心率患者全因死亡率较高。

左室射血分数变化对保留左室射血分数心力衰竭患者预后影响

评估左室射血分数(LVEF)变化对保留射血分数的心力衰竭(HFpEF)患者预后的影响。方法 研究对象为108例HFpEF患者。根据入院及出院6个月内LVEF变化,将患者分为3组:76例患者LVEF≥50%(HFpEF组),14例患者LVEF在40%-49%(中度EF组,HFmrEF组),18例患者LVEF低于40%(HFrEF组)。采用逻辑回归分析临床特征与HFrEF之间的关联;采用Cox比例风险模型评估LVEF变化作为心脏事件发生率预测指标。结果 逻辑回归分析显示,年龄较大、冠心病、院时肌钙蛋白I和左室舒张末内径(LVDd)水平较高及LVEF水平较低是HFrEF(HFpEF恶化)预测因素。在Cox比例风险模型分析中,HFrEF(vs HFpEF)是心脏事件发生率增加的独立预测因子(HR: 1.432,95%CI:1.022-1.867,P<0.001)。结论入院及出院6个月内LVEF变化是HFpEF患者心脏事件发生率增加的预测因素。