Glucose dysregulation and repolarization variability markers are short-term mortality predictors in decompensated heart failure

IF 1.3 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
G. Piccirillo, F. Moscucci, M. Carnovale, A. Corrao, I. Di Diego, I. Lospinuso, S. Sciomer, P. Rossi, D. Magrí
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引用次数: 1

Abstract

Objective As recently reported, elevated fasting glucose plasma level constitutes a risk factor for 30-day total mortality in acutely decompensated chronic heart failure (CHF). Aim of this study was to evaluate the 30-day mortality risk in decompensated CHF patients by fasting glucose plasma level and some repolarization ECG markers. Method A total of 164 decompensated CHF patients (M/F: 94/71; mean age, 83 ± 10 years) were studied; Tend (Te), QT interval (QT) and 5 min of ECG recordings were obtained, studying mean, SD and normalized index of the abovementioned ECG intervals. These repolarization variables and fasting glucose were analyzed to assess the 30-day mortality risk among these patients. Results Thirty-day mortality rate was 21%, deceased subjects showed a significant increase in N terminal-pro-brain natriuretic peptide (P < 0.001), higher sensitivity cardiac troponin, fasting glucose, creatinine clearance, QTSD, QTVN, Te mean, TeSD and TeVN than the survivals. Multivariable regression analysis reported that fasting glucose (hazard ratio, 1.59; 95% confidence interval, 1.09–2.10; P < 0.01), Te mean (hazard ratio, 1.03; 95% confidence interval, 1.01–1.05; P < 0.01) and QTSD (hazard ratio, 1.17; 95% confidence interval, 1.01–1.36; P < 0.05) were significantly related to higher mortality risk, whereas only fasting glucose (hazard ratio, 1.84; 95% confidence interval, 1.12–3.02; P < 0.05) and Te mean (hazard ratio, 1.07; 95% confidence interval, 1.02–1.11; P < 0.01) were associated to cardiovascular mortality. Conclusion Data suggest that two simple, inexpensive, noninvasive markers, as fasting glucose and Te, were capable to stratify the short-term total and cardiovascular mortality risk in acutely decompensated CHF.
葡萄糖失调和复极化变异性标记物是失代偿性心力衰竭的短期死亡率预测因子
最近有报道称,空腹血糖水平升高是急性失代偿性慢性心力衰竭(CHF)患者30天总死亡率的一个危险因素。本研究的目的是通过空腹血糖水平和一些复极心电图指标来评估失代偿期CHF患者30天死亡风险。方法164例失代偿期CHF患者(M/F: 94/71;平均年龄(83±10岁);取心电图的Tend (Te)、QT间期(QT)和5min记录,研究上述心电图间期的均值、标准差和归一化指数。对这些复极变量和空腹血糖进行分析,以评估这些患者的30天死亡风险。结果30天死亡率为21%,死亡患者N端脑钠肽前体明显高于生者(P < 0.001),心肌肌钙蛋白、空腹血糖、肌酐清除率、QTSD、QTVN、Te平均值、TeSD和TeVN的敏感性高于生者。多变量回归分析报告空腹血糖(风险比,1.59;95%置信区间为1.09-2.10;P < 0.01),平均(风险比1.03;95%置信区间为1.01-1.05;P < 0.01)和QTSD(风险比1.17;95%置信区间为1.01-1.36;P < 0.05)与较高的死亡风险显著相关,而仅与空腹血糖相关(危险比,1.84;95%置信区间为1.12-3.02;P < 0.05)和平均值(风险比1.07;95%置信区间为1.02-1.11;P < 0.01)与心血管死亡率相关。结论数据表明,空腹血糖和Te这两个简单、廉价、无创的指标能够对急性失代偿期CHF的短期总死亡风险和心血管死亡风险进行分层。
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来源期刊
Cardiovascular Endocrinology & Metabolism
Cardiovascular Endocrinology & Metabolism CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
5.60
自引率
0.00%
发文量
24
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