医学
心脏病学
心室
射血分数
内科学
心力衰竭
射血分数保留的心力衰竭
临床终点
心房颤动
临床试验
作者
Masamichi Yano,Masami Nishino,Shodai Kawanami,Hiroki Sugae,Kohei Ukita,Akito Kawamura,Koji Yasumoto,Masaki Tsuda,Naotaka Okamoto,Yasuharu Matsunaga‐Lee,Yasuyuki Egami,Jun Tanouchi,Takahisa Yamada,Yoshio Yasumura,Masahiro Seo,Toshimitsu Hayashi,Akito Nakagawa,Yusuke Nakagawa,Shunsuke Tamaki,Yohei Sotomi,Daisaku Nakatani,Shungo Hikoso,Yasushi Sakata
出处
期刊:International Heart Journal
[International Heart Journal Association]
日期:2023-09-30
卷期号:64 (5): 875-884
摘要
Two key echocardiographic parameters, left ventricular mass index (LVMI) and left atrial volume index (LAVI), are important in assessing structural myocardial changes in heart failure (HF) with preserved ejection fraction (HFpEF). However, the differences in clinical characteristics and outcomes among groups classified by LVMI and LAVI values are unclear.We examined the data of 960 patients with HFpEF hospitalized due to acute decompensated HF from the PURSUIT-HFpEF registry, a prospective, multicenter observational study. Four groups were classified according to the cut-off values of LVMI and LAVI [LVMI = 95 g/m2 (female), 115 g/m2 (male) and LAVI = 34 mL/m2]. Clinical endpoints were the composite of HF readmission and all-cause death. Study endpoints among the 4 groups were evaluated. The composite endpoint occurred in 364 patients (37.9%). Median follow-up duration was 445 days. Kaplan-Meier analysis revealed significant differences in the composite endpoint among the 4 groups (P < 0.001). Cox proportional hazards analysis demonstrated that patients with increased LAVI alone were at significantly higher risk of HF readmission and the composite endpoints than those with increased LVMI alone (P = 0.030 and P = 0.024, respectively). Age, male gender, systolic blood pressure at discharge, atrial fibrillation (AF) hemoglobin, renal function, and LAVI were significant determinants of LVMI and female gender, AF, hemoglobin, and LVMI were significant determinants of LAVI.In HFpEF patients, increased LAVI alone was more strongly associated with HF readmission and the composite of HF readmission and all-cause death than those with increased LVMI alone.