峰值氧耗量对非射血分数减低的心力衰竭患者预后评估的价值

目的:探讨心肺运动试验重要参数对非射血分数减低心力衰竭(HFr EF)预后评价的价值。方法:前瞻性入组2014年1月到2018年6月,我院诊断为非HFr EF患者,记录患者再入院及死亡事件,最后进行生存分析。结果:入选124例患者,平均随访(24±5)个月,10例患者死亡,32例患者因心力衰竭再住院治疗。心力衰竭组患者峰值氧耗量劣于正常健康对照组(17.4±2.7)vs.(31.5±3.2)m L·kg^-1·min^-1,P<0.05]。事件组峰值氧耗量低于无事件组(13.9±2.1)vs.(19.2±3.5)m L·kg^-1·min^-1,P<0.05]。多因素分析表明:峰值氧耗量是预测非HFr EF患者预后的指标(HR=0.81,95%CI:0.76~0.92,P<0.002)。结论:峰值氧耗量可以很好预测非HFr EF患者预后。

The value of peak oxygen uptake in predicting prognosis in patients with heart failure with not reduced ejection fraction

Objective:To evaluate the value of parameters from cardiopulmonary exercise test in predicting the prognosis in patients with heart failure with not reduced ejection fraction.Methods:Patients with heart failure with not reduced ejection fraction were enrolled from January 2014 to June 2018 in our hospital.The events of rehospitalization due to heart failure and any cause of death were recorded and multivariate Cox regression analysis was performed to assess the survival rate.Results:124 patients were enrolled and the mean follow-up period was 24±5 months,10 patients died and 32 patients readmitted in hospital due to heart failure.Peak oxygen uptake is lower in the group of patients with heart failure compared with that in the group of patients with healthy people(17.4±2.7)vs.(31.5±3.2)m L·kg^-1·min^-1,P<0.05].Peak oxygen uptake is lower in the group of patients who died or rehospitalization compared with that in the group of patients who did not die or rehospitalization(13.9±2.1)vs.(19.2±3.5)m L·kg^-1·min^-1,P<0.05].Multivariate Cox analysis demonstrated that peak oxygen uptake could independently predict prognosis(HR=0.81,95%CI:0.76-0.92,P<0.002).Conclusions:Peak oxygen uptake can independently predict prognosis of patients with heart failure with not reduced ejection fraction.