Suy tim cấp tính với phân suất tống máu giảm nhẹ và nhồi máu cơ tim: một nghiên cứu nhóm đa viện

BMC Cardiovascular Disorders - Tập 23 - Trang 1-11 - 2023
Ming-Shyan Lin1,2,3, Po-Chang Wang1, Meng-Hung Lin4, Ting-Yu Kuo4, Yu-Sheng Lin1, Tien-Hsing Chen5, Ming-Horng Tsai6, Yao-Hsu Yang4,7,8, Chun-Liang Lin9, Chang-Min Chung1, Pao-Hsien Chu10,11
1Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital Chiayi Branch, Chiayi, Taiwan
2Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
3Department of Nursing, Chang Gung University of Science and Technology, Chiayi, Taiwan
4Health Information and Epidemiology Laboratory, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan
5Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital Chiayi Branch, Keelung, Taiwan
6Department of Pediatrics, Chang Gung Memorial Hospital, Yunlin, Taiwan
7Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan
8School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
9Department of Nephrology, Chang Gung Memorial Hospital Chiayi Branch, Chiayi, Taiwan
10Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital Linkou Branch, Taoyuan, Taiwan
11Institute of Stem Cell and Translational Cancer Research, Chang Gung Memorial Hospital Chang Gung University College of Medicine, Taipei, Taiwan

Tóm tắt

Có rất ít nghiên cứu được tiến hành về những kết quả thiếu máu não liên quan đến phân suất tống máu thất trái (EF) trong suy tim cấp tính không bù (ADHF). Một nghiên cứu hồi cứu đã được thực hiện giữa năm 2001 và 2021 sử dụng Cơ sở dữ liệu Nghiên cứu Chang Gung. Những bệnh nhân ADHF được xuất viện từ các bệnh viện trong khoảng thời gian từ ngày 1 tháng 1 năm 2005 đến ngày 31 tháng 12 năm 2019. Tử vong tim mạch (CV) và tái nhập viện do suy tim (HF) là các thành phần kết quả chính, cùng với tử vong do mọi nguyên nhân, nhồi máu cơ tim cấp tính (AMI) và đột quỵ. Tổng cộng có 12.852 bệnh nhân ADHF đã được xác định, trong đó 2.222 (17,3%) có tình trạng HFmrEF, tuổi trung bình (SD) là 68,5 (14,6) năm, và 1.327 (59,7%) là nam giới. So với bệnh nhân HFrEF và HFpEF, bệnh nhân HFmrEF có phenotyp khác biệt đi kèm với tiểu đường, rối loạn lipid máu và bệnh tim thiếu máu cục bộ. Bệnh nhân có HFmrEF có khả năng cao hơn trong việc trải nghiệm suy thận, chạy thận nhân tạo và thay thế. Cả HFmrEF và HFrEF đều có tỷ lệ sốc điện tim và can thiệp mạch vành giống nhau. Kết quả lâm sàng ở mức trung gian giữa HFpEF và HFrEF, nhưng HFmrEF có tỷ lệ AMI cao nhất (HFpEF, 9,3%; HFmrEF, 13,6%; HFrEF, 9,9%). Tỷ lệ AMI ở HFmrEF cao hơn so với HFpEF (AHR, 1,15; Khoảng tin cậy 95%, 0,99 đến 1,32) nhưng không cao hơn so với HFrEF (AHR, 0,99; Khoảng tin cậy 95%, 0,87 đến 1,13). Suy nén cấp tính ở bệnh nhân HFmrEF làm tăng nguy cơ nhồi máu cơ tim. Mối quan hệ giữa HFmrEF và bệnh cơ tim thiếu máu cục bộ, cũng như điều trị chống thiếu máu tối ưu, cần được nghiên cứu rộng rãi hơn.

Từ khóa


Tài liệu tham khảo

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