医学
射血分数
内科学
心脏病学
心力衰竭
危险系数
射血分数保留的心力衰竭
置信区间
舒张期
比例危险模型
血压
作者
Bahira Shahim,Angiza Shahim,Marianna Adamo,Ovidiu Chioncel,Lina Benson,Bahira Shahim,María G. Crespo‐Leiro,Stefan D. Anker,Andrew J.S. Coats,Gerasimos Filippatos,Mitja Lainščak,Theresa A. McDonagh,Alexandre Mebazaa,Massimo Piepoli,Giuseppe M.C. Rosano,Frank Ruschitzka,Gianluigi Savarese,Petar Seferović,Maurizio Volterrani,María G. Crespo-Leiro,Javier Segovia Cubero,Offer Amir,B. Palic,Aldo P. Maggioni,Marco Metra,Lars H. Lund
摘要
ABSTRACT Aims To assess the prevalence, clinical characteristics, and outcomes of patients with heart failure (HF) with or without moderate to severe aortic valve disease (AVD) (aortic stenosis [AS], aortic regurgitation [AR], mixed AVD [MAVD]). Methods and results Data from the prospective ESC HFA EORP HF Long‐Term Registry including both chronic and acute HF were analysed. Of 15 216 patients with HF (62.5% with reduced ejection fraction, HFrEF; 14.0% with mildly reduced ejection fraction, HFmrEF; 23.5% with preserved ejection fraction, HFpEF), 706 patients (4.6%) had AR, 648 (4.3%) AS and 234 (1.5%) MAVD. The prevalence of AS, AR and MAVD was 6%, 8%, and 3% in HFpEF, 6%, 3%, and 2% in HFmrEF and 4%, 3%, and 1% in HFrEF. The strongest associations were observed for age and HFpEF with AS, and for left ventricular end‐diastolic diameter with AR. AS (adjusted hazard ratio [HR] 1.43, 95% confidence interval [CI] 1.23–1.67), and MAVD (adjusted HR 1.37, 95% CI 1.07–1.74) but not AR (adjusted HR 1.13, 95% CI 0.96–1.33) were independently associated with the 12‐month composite outcome of cardiovascular death and HF hospitalization. The associations between AS and the composite outcome were observed regardless of ejection fraction category. Conclusions In the ESC HFA EORP HF Long‐Term Registry, one in 10 patients with HF had AVD, with AS and MAVD being especially common in HFpEF and AR being similarly distributed across all ejection fraction categories. AS and MAVD, but not AR, were independently associated with increased risk of in‐hospital mortality and 12‐month composite outcome, regardless of ejection fraction category.