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Luigi Paolo Badano Maria C Albanese Paola De Biaggio Patrizia Rozbowsky Daniela Miani Claudio Fresco Paolo M Fioretti 《Journal of the American Society of Echocardiography》2004,17(3):253-261
Prevalence of isolated left ventricular (LV) diastolic dysfunction has been reported to be as high as one-third of all heart failure (HF) cases, with an increasing prevalence in the elderly population. However, there is a paucity of prospective data about the prevalence and prognosis of isolated LV diastolic dysfunction in an unselected population of patients hospitalized with HF. Therefore, we prospectively evaluated 179 consecutive patients discharged from our hospital with HF to assess the prevalence of systolic versus diastolic LV dysfunction among patients hospitalized with HF and to compare their demographics, clinical features, self-perceived quality of life (QOL), and 6-month readmission rate and mortality. Among them, 133 (59% men, median age 74 years) showed in sinus rhythm and had no significant primary valvular disease. LV diastolic dysfunction was diagnosed on the basis of the European Study Group on Diastolic HF echocardiographic criteria. QOL was assessed at hospital discharge and 6-month follow-up visit using the Minnesota Living with HF questionnaire. Survival of patients with HF was compared with that of age- and sex-matched general population. In all, 29 patients (22%) had isolated LV diastolic dysfunction and 102 (78%) had prevalent LV systolic dysfunction (ie, LV ejection fraction = 45%). There was no difference in age, sex, or New York Heart Association functional class between patients with LV diastolic or systolic dysfunction. QOL scores were similar between the 2 patient groups with HF both at discharge (39.4 and 34) and at 6-month visit (10.4 and 10.4). Both 6-month readmission rate (48% and 48%) and median inhospital length-of-stay during readmissions (10 days and 10 days) were similar between the 2 patient groups with HF. Finally, 6-month survival, adjusted for age and sex, was similar between patients with LV diastolic or systolic dysfunction (hazard ratio 0.68; 95% confidence interval 0.20-2.35). Using standardized echocardiographic criteria, isolated LV diastolic dysfunction among unselected patients hospitalized with HF was less than previously reported. Patients with HF and isolated diastolic dysfunction showed similar clinical symptoms, self-perceived QOL, readmission rate, and 6-month mortality to patients with prevalent LV systolic dysfunction. 相似文献
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筛检对肝癌死亡率影响的研究 总被引:5,自引:0,他引:5
5581名HBsAg阳性的男性随机分入周期性筛检组(A组,3712人)及对照组(B组,1869人)。A组(19155.4人年)共发生肝癌257例,B组(9785.5人年)为117例,两组的肝癌发生率分别为1342/10万与1196/10万;两组肝癌死亡分别为218与109例,肝癌死亡率分别为1138/10万与1114/10万。两组中Ⅰ期肝癌病例分别为29.6%与6.0%,差异有非常显著性意义。1、3、5年相对生存率A组为23.7%、7.0%、4.0%,B组为9.7%、4.0%、4.1%。用Poisson回归模型拟合显示,在调正年龄、初筛AFP及入列年份后,筛检对于肝癌的相对危险度为0.83,95%CI为0.68~1.03,有较弱的“保护”作用,Cox回归模型拟合结果显示当临床分期未引入模型时,筛检对于肝癌有显著的“保护”作用:危险率为0.6617,95%CI为0.5234~0.8365;而模型经调整后,危险率即接近“1”,95%CI为0.74~1.26。 相似文献