Background:Clinical features and outcomes of heart failure(HF)with mid-range ejection fraction(HFmrEF)remain controversial.Thus,we systematically reviewed literatures of clinical research to assess and analyze charact...Background:Clinical features and outcomes of heart failure(HF)with mid-range ejection fraction(HFmrEF)remain controversial.Thus,we systematically reviewed literatures of clinical research to assess and analyze characteristics and prognosis of patients with HFmrEF.Methods:PubMed,Embase,and Web of Science were searched for cohort studies up to April 23,2019.Clinical features and multivariate adjusted hazard ratios(HRs)of endpoints of short-term all-cause mortality(SAM),long-term all-cause mortality(LAM),long-term cardiovascular death(LCD)and long-term HF rehospitalization(LHR)among patients with HFmrEF and HF with preserved ejection fraction(HFpEF),HF with reduced ejection fraction(HFrEF)were well addressed.The primary outcome was LAM.Results:Totally 19 studies were included in this study with 164,678 patients enrolled.The follow-up time of LAM was 3.6±2.5 years.HRs of LAM,SAM,LCD,LHR indicated that the risks of patients with HFmrEF were higher than HFpEF patients but lower than HFrEF patients,as for LAM,HFmrEF:HFpEF(reference)HR:1.07,95%confidence interval(CI):1.00-1.15(I2=63%,P=0.0005);HFmrEF:HFrEF(reference)HR:0.80,95%CI:0.73-0.88(I2=70%,P<0.0001).However,HFmrEF patients had the lowest rate in LAM(30.94%),SAM(2.73%),LCD(17.45%),LHR(26.36%)compared with the other two groups.Conclusions:This systematic review and meta-analysis compared features and prognosis between patients with HFmrEF and HFpEF,HFrEF by HRs.There appeared a special"separation phenomenon"showing rates of endpoints were inconsistent with their hazards in patients with HFmrEF compared with HFpEF patients.展开更多
Objective To determine the effect of the phosphodiesterase-5 inhibitor sildenafil compared with placebo on exercise capacity and clinical status in HFPEF. Design Multicenter, double-blind, placebo-controlled, paralle...Objective To determine the effect of the phosphodiesterase-5 inhibitor sildenafil compared with placebo on exercise capacity and clinical status in HFPEF. Design Multicenter, double-blind, placebo-controlled, parallel-group, randomized clinical trial of 216 sta- ble outpatients with HF, ejection fraction ≥ 50%, elevated N-terminal brain-type natriuretic peptide or elevat- ed invasively measured filling pressures, and reduced exercise capacity. Participants were randomized from October 2008 through February 2012 at 26 centers in North America. Follow-up was through August 30, 2012.展开更多
目的探讨V1导联P波终末电势(P wave terminal force in lead V1,PtfV1)在心功能不全患者中的临床应用价值。方法 110例心功能不全患者及100例正常对照组纳入研究。测量、计算、记录所有入选者的体表心电图PtfV1数值,超声心动图左室射血...目的探讨V1导联P波终末电势(P wave terminal force in lead V1,PtfV1)在心功能不全患者中的临床应用价值。方法 110例心功能不全患者及100例正常对照组纳入研究。测量、计算、记录所有入选者的体表心电图PtfV1数值,超声心动图左室射血分数(LVEF)以及性别、年龄、民族等相关临床指标。按照纽约心功能分级(NYHA)将病例组分为轻症组(NYHAⅠ~Ⅱ)及重症组(NYHAⅢ~Ⅳ)。按照LEVF下降程度将病历组分为LEVF轻度下降组(LVEF 40%~50%)及中重度下降组LVEF<40%。分别比较心功能不全患者与正常人,NYHA分级严重程度不同的患者之间相较,LEVF下降程度不同的患者之间相较,PtfV1数值的差异。并分析PtfV1与传统评价心功能严重程度的指标LVEF之间的相关性。结果 1心功能不全患者与对照组相较,PtfV1数值明显下降(p<0.05);2NYHA分级重症心功能不全患者较轻症患者的PtfV1数值明显下降(p<0.05);3LVEF中重度降低患者与轻度降低的患者相较,Ptfv1数值明显下降(p<0.05);4PtfV1与LVEF呈显著正相关,相关系数r=0.77,p<0.01。结论 V1导联P波终末电势(PtfV1)可作为评价心功能不全患者病情严重程度的一项临床心电学指标。展开更多
基金This study was supported by grants from the China Cardiovascular Association-Cardiac Rehabilitation and Metabolic Therapy Research Fund(No.CCA-CRMT-1805)the Science and Technology Funding of Tianjin Chest Hospital(No.2018XKZ17).
文摘Background:Clinical features and outcomes of heart failure(HF)with mid-range ejection fraction(HFmrEF)remain controversial.Thus,we systematically reviewed literatures of clinical research to assess and analyze characteristics and prognosis of patients with HFmrEF.Methods:PubMed,Embase,and Web of Science were searched for cohort studies up to April 23,2019.Clinical features and multivariate adjusted hazard ratios(HRs)of endpoints of short-term all-cause mortality(SAM),long-term all-cause mortality(LAM),long-term cardiovascular death(LCD)and long-term HF rehospitalization(LHR)among patients with HFmrEF and HF with preserved ejection fraction(HFpEF),HF with reduced ejection fraction(HFrEF)were well addressed.The primary outcome was LAM.Results:Totally 19 studies were included in this study with 164,678 patients enrolled.The follow-up time of LAM was 3.6±2.5 years.HRs of LAM,SAM,LCD,LHR indicated that the risks of patients with HFmrEF were higher than HFpEF patients but lower than HFrEF patients,as for LAM,HFmrEF:HFpEF(reference)HR:1.07,95%confidence interval(CI):1.00-1.15(I2=63%,P=0.0005);HFmrEF:HFrEF(reference)HR:0.80,95%CI:0.73-0.88(I2=70%,P<0.0001).However,HFmrEF patients had the lowest rate in LAM(30.94%),SAM(2.73%),LCD(17.45%),LHR(26.36%)compared with the other two groups.Conclusions:This systematic review and meta-analysis compared features and prognosis between patients with HFmrEF and HFpEF,HFrEF by HRs.There appeared a special"separation phenomenon"showing rates of endpoints were inconsistent with their hazards in patients with HFmrEF compared with HFpEF patients.
文摘Objective To determine the effect of the phosphodiesterase-5 inhibitor sildenafil compared with placebo on exercise capacity and clinical status in HFPEF. Design Multicenter, double-blind, placebo-controlled, parallel-group, randomized clinical trial of 216 sta- ble outpatients with HF, ejection fraction ≥ 50%, elevated N-terminal brain-type natriuretic peptide or elevat- ed invasively measured filling pressures, and reduced exercise capacity. Participants were randomized from October 2008 through February 2012 at 26 centers in North America. Follow-up was through August 30, 2012.
基金National Natural Science Foundation of China (81673955)Provincial Key Research and Development Project of Hunan (2022SK2012)Hunan University of Chinese Medicine Graduate Innovation Project (2022CX133)。
文摘目的探讨V1导联P波终末电势(P wave terminal force in lead V1,PtfV1)在心功能不全患者中的临床应用价值。方法 110例心功能不全患者及100例正常对照组纳入研究。测量、计算、记录所有入选者的体表心电图PtfV1数值,超声心动图左室射血分数(LVEF)以及性别、年龄、民族等相关临床指标。按照纽约心功能分级(NYHA)将病例组分为轻症组(NYHAⅠ~Ⅱ)及重症组(NYHAⅢ~Ⅳ)。按照LEVF下降程度将病历组分为LEVF轻度下降组(LVEF 40%~50%)及中重度下降组LVEF<40%。分别比较心功能不全患者与正常人,NYHA分级严重程度不同的患者之间相较,LEVF下降程度不同的患者之间相较,PtfV1数值的差异。并分析PtfV1与传统评价心功能严重程度的指标LVEF之间的相关性。结果 1心功能不全患者与对照组相较,PtfV1数值明显下降(p<0.05);2NYHA分级重症心功能不全患者较轻症患者的PtfV1数值明显下降(p<0.05);3LVEF中重度降低患者与轻度降低的患者相较,Ptfv1数值明显下降(p<0.05);4PtfV1与LVEF呈显著正相关,相关系数r=0.77,p<0.01。结论 V1导联P波终末电势(PtfV1)可作为评价心功能不全患者病情严重程度的一项临床心电学指标。
