HFpEF、HFmrEF和HFrEF的临床特征及左心室重塑对比分析

目的:探讨射血分数保留的心衰(HFpEF)、射血分数中间范围的心衰(HFmr EF)和射血分数下降的心衰(HFr EF)患者临床特征及左心室重塑的差别。方法:选取2013年2月1日至2016年12月31日在我院心内住院的308名心力衰竭患者作为研究对象,根据入院后首次心脏彩超结果,按左室射血分数(LVEF)将入选的心力衰竭患者分为HFr EF组、HFmr EF组和HFpEF组,回顾性分析所有患者的临床一般资料、化验结果、超声数据和用药情况,对比分析3组患者的临床特征及左心室重塑的差别。结果:HFpEF组为123例(39.9%),HFmr EF组为98例(31.5%),HFr EF组为88例(28.6%);其中HFpEF组女性比例高于HFr EF组(59.4%vs.38.6%,P0.05),高血压和房颤患病率HFpEF组高于HFr EF组(P0.05);HFpEF组左心室重构类型以向心性重塑为主,HFr EF组则以离心性重塑为主;HFmr EF组女性比例及高血压、房颤患病率等临床特征及左心室重塑类型分布则介于HFpEF组与HFr EF之间。结论:HFpEF,HFmr EF与HFr EF组患者临床特点及左心室重塑类型分布显著不同,应对不同左室射血分数的心力衰竭患者采取更有针对性的治疗措施。

Comparison of the Clinical Features and Left Ventricular Remodeling in Patients with HFpEF, HFmrEF and HFrEF

ABSTRACT Objective: To observe differences of clinical features and left ventricular remodeling in patients with heart failure with preserved ejection fraction (HFpEF), heart failure with mid-range ejection fraction (HFmrEF) and heart failure with reduced ejection frac- tion (HFrEF). Methods: A retrospective study was carried out and we employed medical records of 308 patients, admitted as a result of HF to the Hong Kong University-Shenzhen Hospital in the period between February 01, 2013 and December 31, 2016 due to HF. Results: 1). Of the 308 patients who were admitted due to HF, 123(39.9%) patients met the HFpEF criteria with 31.5% HFmrEF and 28.6% HFrEF. Comparing to HFrEF, HFpEF patients were tend to be more women (59.4%vs.38.6%, P<0.05), more hypertension and atrial fib- rillation. 2). More left ventricular concentric remolding cases were detected in HFpEF patients while more left ventricular eccentric re- molding cases were detected in HFrEF patients. 3). Clinical characteristics and left ventricular remolding types of HFmrEF fall in range between HFpEF and HFrEF. Conclusion: Different clinical characteristics and left ventricular remolding types were found in HFpEF,HFmrEF and HFrEF patients.