PDF(Pubmed)
Abstract：
Cardiac remodeling is frequently observed in patients with heart failure (HF) and serves as an indicator of disease progression and severity. Septal hypertrophy represents an aspect of remodeling that can be easily assessed via an echocardiographic measurement of the interventricular septal end diastole (IVSd), but it has not been evaluated for its prognostic value, particularly in patients with heart failure with mildly reduced ejection fraction (HFmrEF). We retrospectively included 1881 consecutive patients hospitalized with HFmrEF (i.e., a left ventricular ejection fraction of 41-49% and signs and/or symptoms of HF) at one institution during a study period from 2016 to 2022. Septal hypertrophy, defined as an IVSd > 12 mm, was prevalent in 34% of the HFmrEF patients. Although septal hypertrophy was not associated with all-cause mortality at 30 months (median follow-up) (HR = 1.067; 95% CI: 0.898-1.267; p = 0.460), it was associated with an increased risk of hospitalization due to worsening HF at 30 months (HR = 1.303; 95% CI: 1.008-1.685; p = 0.044), which was confirmed even after multivariable adjustment (HR = 1.340; 95% CI: 1.002-1.792; p = 0.049) and propensity score matching (HR = 1.399; 95% CI: 1.002-1.951; p = 0.048). Although septal hypertrophy was not associated with the risk of all-cause mortality in patients with HFmrEF, it was identified as an independent predictor of long-term HF-related rehospitalization.
摘要：
在患有心力衰竭(HF)的患者中经常观察到心脏重塑,并且作为疾病进展和严重程度的指标。室间隔肥大代表重塑的一个方面，可以通过超声心动图测量室间隔末期舒张期（IVSd）轻松评估，但尚未评估其预后价值，特别是在伴有轻度降低的射血分数（HFmrEF）的心力衰竭患者中。我们回顾性地纳入了1881例连续住院的HFmrEF患者(即，在2016年至2022年的研究期间，一家机构的左心室射血分数为41-49%，心力衰竭的体征和/或症状）。间隔肥大,定义为IVSd>12mm，在34％的HFmrEF患者中普遍存在。尽管间隔肥大与30个月时的全因死亡率无关（中位随访时间）（HR=1.067；95％CI：0.898-1.267；p=0.460），它与30个月时HF恶化导致的住院风险增加相关(HR=1.303;95%CI:1.008-1.685;p=0.044),即使在多变量校正(HR=1.340;95%CI:1.002-1.792;p=0.049)和倾向评分匹配(HR=1.399;95%CI:1.002-1.951;p=0.048)后,这一点也得到了证实。尽管室间隔肥大与HFmrEF患者的全因死亡风险无关,它被确定为长期HF相关再住院的独立预测因子.
