心率校正的收缩期射血时间:基于人群的参考值和急性心力衰竭的不同预后效用

Caroline Morbach, Isabelle Simon, Elisabeth Danner, Götz Gelbrich, Ulrich Stefenelli, Floran Sahiti, Nina Scholz, Vladimir Cejka, Judith Albert, Georg Ertl, Christiane E Angermann, Gülmisal Güder, Stefan Frantz, Peter U Heuschmann, Christoph Maack, Stefan Störk
{"title":"心率校正的收缩期射血时间:基于人群的参考值和急性心力衰竭的不同预后效用","authors":"Caroline Morbach, Isabelle Simon, Elisabeth Danner, Götz Gelbrich, Ulrich Stefenelli, Floran Sahiti, Nina Scholz, Vladimir Cejka, Judith Albert, Georg Ertl, Christiane E Angermann, Gülmisal Güder, Stefan Frantz, Peter U Heuschmann, Christoph Maack, Stefan Störk","doi":"10.1093/ehjimp/qyad020","DOIUrl":null,"url":null,"abstract":"Abstract Aims Systolic ejection time (SET) is discussed as a treatment target in patients with heart failure (HF) and a reduced left ventricular (LV) ejection fraction (EF). We derived reference values for SET correcting for its dependence on heart rate (SETc), and explored its prognostic utility in patients admitted with decompensated HF. Methods and results SETc was derived in 4836 participants of the population-based STAAB study (mean age 55 ± 12 years, 52% women). There, mean SETc was 328 ± 18 ms, increased with age (+4.7 ms per decade), was shorter in men than women (−14.9 ms), and correlated with arterial elastance (r = 0.30; all P < 0.001). In 134 patients hospitalized with acute HF, SETc at admission was shorter when compared with the general population and differed between patients with HF with reduced EF (HFrEF; LVEF ≤40%; 269 ± 35 ms), HF with mildly reduced EF (HFmrEF; LVEF 41–49%; 294 ± 27 ms), and HF with preserved EF (HFpEF; LVEF ≥50%; 317 ± 35 ms; P < 0.001). In proportional hazard regression, an in-hospital increase in SETc was associated with an age- and sex-adjusted hazard ratio of 0.38 (95% confidence interval 0.18–0.79) in patients with HFrEF, but a hazard ratio of 2.39 (95% confidence interval 1.24–4.64) in patients with HFpEF. Conclusion In the general population, SETc increased with age and an elevated afterload. SETc was mildly reduced in patients hospitalized with HFpEF, but markedly reduced in patients with HFrEF. In-hospital prolongation of SETc predicted a favourable outcome in HFrEF, but an adverse outcome in HFpEF. Our results support the concept of a U-shaped relationship between cardiac systolic function and risk, providing a rationale for a more individualized treatment approach in patients with HF.","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Heart rate–corrected systolic ejection time: population-based reference values and differential prognostic utility in acute heart failure\",\"authors\":\"Caroline Morbach, Isabelle Simon, Elisabeth Danner, Götz Gelbrich, Ulrich Stefenelli, Floran Sahiti, Nina Scholz, Vladimir Cejka, Judith Albert, Georg Ertl, Christiane E Angermann, Gülmisal Güder, Stefan Frantz, Peter U Heuschmann, Christoph Maack, Stefan Störk\",\"doi\":\"10.1093/ehjimp/qyad020\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Abstract Aims Systolic ejection time (SET) is discussed as a treatment target in patients with heart failure (HF) and a reduced left ventricular (LV) ejection fraction (EF). We derived reference values for SET correcting for its dependence on heart rate (SETc), and explored its prognostic utility in patients admitted with decompensated HF. Methods and results SETc was derived in 4836 participants of the population-based STAAB study (mean age 55 ± 12 years, 52% women). There, mean SETc was 328 ± 18 ms, increased with age (+4.7 ms per decade), was shorter in men than women (−14.9 ms), and correlated with arterial elastance (r = 0.30; all P < 0.001). In 134 patients hospitalized with acute HF, SETc at admission was shorter when compared with the general population and differed between patients with HF with reduced EF (HFrEF; LVEF ≤40%; 269 ± 35 ms), HF with mildly reduced EF (HFmrEF; LVEF 41–49%; 294 ± 27 ms), and HF with preserved EF (HFpEF; LVEF ≥50%; 317 ± 35 ms; P < 0.001). In proportional hazard regression, an in-hospital increase in SETc was associated with an age- and sex-adjusted hazard ratio of 0.38 (95% confidence interval 0.18–0.79) in patients with HFrEF, but a hazard ratio of 2.39 (95% confidence interval 1.24–4.64) in patients with HFpEF. Conclusion In the general population, SETc increased with age and an elevated afterload. SETc was mildly reduced in patients hospitalized with HFpEF, but markedly reduced in patients with HFrEF. In-hospital prolongation of SETc predicted a favourable outcome in HFrEF, but an adverse outcome in HFpEF. Our results support the concept of a U-shaped relationship between cardiac systolic function and risk, providing a rationale for a more individualized treatment approach in patients with HF.\",\"PeriodicalId\":94317,\"journal\":{\"name\":\"European heart journal. Imaging methods and practice\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European heart journal. Imaging methods and practice\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1093/ehjimp/qyad020\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European heart journal. Imaging methods and practice","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1093/ehjimp/qyad020","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

摘要

目的探讨收缩期射血时间(SET)作为心力衰竭(HF)和左室射血分数(EF)降低患者的治疗目标。我们推导了校正SET依赖于心率(SETc)的参考值,并探讨了其在失代偿性心衰患者中的预后效用。方法和结果:在以人群为基础的STAAB研究中,4836名参与者(平均年龄55±12岁,52%为女性)获得了SETc。平均SETc为328±18 ms,随着年龄的增长而增加(每10年增加4.7 ms),男性比女性短(- 14.9 ms),并与动脉弹性相关(r = 0.30;P <0.001)。在134例急性HF住院患者中,与一般人群相比,入院时SETc较短,EF降低的HF患者之间存在差异(HFrEF;LVEF≤40%;269±35 ms), HF伴EF轻度降低(HFmrEF;LVEF 41 - 49%;294±27 ms), HF伴保存EF (HFpEF;LVEF≥50%;317±35 ms;P, lt;0.001)。在比例风险回归中,HFrEF患者的住院SETc增加与年龄和性别调整后的风险比为0.38(95%可信区间0.18-0.79)相关,而HFpEF患者的风险比为2.39(95%可信区间1.24-4.64)。结论在一般人群中,SETc随年龄和后负荷的增加而增加。在HFpEF住院患者中,SETc轻度降低,但在HFrEF患者中显著降低。院内SETc延长预示着HFrEF的有利结果,但预示着HFpEF的不利结果。我们的研究结果支持心脏收缩功能与风险之间呈u型关系的概念,为心衰患者更个性化的治疗方法提供了理论依据。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Heart rate–corrected systolic ejection time: population-based reference values and differential prognostic utility in acute heart failure
Abstract Aims Systolic ejection time (SET) is discussed as a treatment target in patients with heart failure (HF) and a reduced left ventricular (LV) ejection fraction (EF). We derived reference values for SET correcting for its dependence on heart rate (SETc), and explored its prognostic utility in patients admitted with decompensated HF. Methods and results SETc was derived in 4836 participants of the population-based STAAB study (mean age 55 ± 12 years, 52% women). There, mean SETc was 328 ± 18 ms, increased with age (+4.7 ms per decade), was shorter in men than women (−14.9 ms), and correlated with arterial elastance (r = 0.30; all P &lt; 0.001). In 134 patients hospitalized with acute HF, SETc at admission was shorter when compared with the general population and differed between patients with HF with reduced EF (HFrEF; LVEF ≤40%; 269 ± 35 ms), HF with mildly reduced EF (HFmrEF; LVEF 41–49%; 294 ± 27 ms), and HF with preserved EF (HFpEF; LVEF ≥50%; 317 ± 35 ms; P &lt; 0.001). In proportional hazard regression, an in-hospital increase in SETc was associated with an age- and sex-adjusted hazard ratio of 0.38 (95% confidence interval 0.18–0.79) in patients with HFrEF, but a hazard ratio of 2.39 (95% confidence interval 1.24–4.64) in patients with HFpEF. Conclusion In the general population, SETc increased with age and an elevated afterload. SETc was mildly reduced in patients hospitalized with HFpEF, but markedly reduced in patients with HFrEF. In-hospital prolongation of SETc predicted a favourable outcome in HFrEF, but an adverse outcome in HFpEF. Our results support the concept of a U-shaped relationship between cardiac systolic function and risk, providing a rationale for a more individualized treatment approach in patients with HF.
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信