胸胸比作为保留射血分数的心力衰竭的预后指标。

IF 2.6 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Masato Okada, Koichi Inoue, Toshinari Onishi, Nobuaki Tanaka, Katsuomi Iwakura, Masahiro Seo, Takaharu Hayashi, Masamichi Yano, Akito Nakagawa, Yusuke Nakagawa, Shunsuke Tamaki, Yoshio Yasumura, Takahisa Yamada, Shungo Hikoso, Daisuke Sakamoto, Katsuki Okada, Daisaku Nakatani, Yohei Sotomi, Yasushi Sakata
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引用次数: 0

摘要

背景:心胸比值(CTR),来源于胸部x线,是一种确定的量化心脏大小的指标,在获得性心脏病中具有预后价值。然而,它与保留射血分数(HFpEF)心力衰竭的超声心动图参数和临床结果的关系仍然没有充分的表征。方法:本分析是通过对HFpEF进行前瞻性多中心观察登记的PURSUIT-HFpEF Registry进行的。在登记的1238例患者中,纳入了1195例出院时CTR数据。患者分为三组:CTR结果:出院时中位CTR为56 %(四分位数范围:51-61 %)。在多普勒超声心动图上,CTR升高与血流动力学受损有关,但与左室舒张末期或收缩末期容积指数无关。相反,CTR了温和的相关性与左心室容积指数(r = 0.39),索引右心室直径(0.28 r = ),呼气末下腔静脉直径(0.30 r = ),和LV质量指数(r = 0.18)(所有p 结论:患者HFpEF,增加点击率反映血流动力学妥协,左心房增大和右侧室没有LV腔扩张。CTR≥60 %独立预测不良临床结果,支持其在该人群中的风险分层价值。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cardiothoracic ratio as a prognostic marker in heart failure with preserved ejection fraction.

Background: The cardiothoracic ratio (CTR), derived from chest X-ray, is an established metric for quantifying cardiac size and has prognostic value in acquired heart disease. However, its association with echocardiographic parameters and clinical outcomes in heart failure with preserved ejection fraction (HFpEF) remains inadequately characterized.

Methods: This analysis was performed using the PURSUIT-HFpEF registry, a prospective multicenter observational study for HFpEF. Among 1238 patients registered, 1195 with CTR data at discharge were included. Patients were categorized into three groups: CTR <50 % (N = 199), 50-59 % (N = 631), and ≥60 % (N = 365). Associations of CTR with echocardiographic indices and clinical outcomes were evaluated.

Results: The median CTR at discharge was 56 % (interquartile range: 51-61 %). Increased CTR was associated with impaired hemodynamics on Doppler echocardiography but not with the left ventricular (LV) end-diastolic or end-systolic volume indices. Conversely, CTR demonstrated moderate correlations with the left atrial volume index (r = 0.39), indexed right ventricular diameter (r = 0.28), inferior vena cava end-expiratory diameter (r = 0.30), and LV mass index (r = 0.18) (all p < 0.001). During a 36-month follow-up, 687 patients experienced the composite of death or rehospitalization for heart failure. Event rates increased with the CTR category (<50 %: 44.2 % vs. 50-59 %: 57.2 % vs. ≥60 %: 65.2 %; log-rank p < 0.001). Compared with CTR <50 %, CTR ≥60 % independently predicted the composite endpoint (hazard ratio, 1.47; 95 % confidence interval, 1.09-1.98; p = 0.011) after multivariable adjustment.

Conclusions: In patients with HFpEF, increased CTR reflected hemodynamic compromise, along with enlargement of the left atrium and right-sided chambers without LV cavity dilatation. CTR ≥60 % independently predicted adverse clinical outcomes, supporting its value for risk stratification in this population.

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来源期刊
Journal of cardiology
Journal of cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
4.90
自引率
8.00%
发文量
202
审稿时长
29 days
期刊介绍: The official journal of the Japanese College of Cardiology is an international, English language, peer-reviewed journal publishing the latest findings in cardiovascular medicine. Journal of Cardiology (JC) aims to publish the highest-quality material covering original basic and clinical research on all aspects of cardiovascular disease. Topics covered include ischemic heart disease, cardiomyopathy, valvular heart disease, vascular disease, hypertension, arrhythmia, congenital heart disease, pharmacological and non-pharmacological treatment, new diagnostic techniques, and cardiovascular imaging. JC also publishes a selection of review articles, clinical trials, short communications, and important messages and letters to the editor.
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