■二尖瓣返流(MR)是心力衰竭(HF)的常见并发症之一。很少研究MR的患病率和特征,尤其是中国人。
■这项研究的目的是确定HF患者和通过射血分数定义的亚组中非器质性MR的患病率和特征。
■单中心,以医院为基础,回顾性图表回顾研究纳入了2017年1月至2020年4月心血管内科收治的心力衰竭患者.人口特征,实验室结果,出院前的超声心动图结果采用logistic回归分析由左心室射血分数(EF)定义的不同组,并校正了混杂因素.
■最后,纳入2418名经过验证的HF患者(年龄67.2±13.5岁;68.03%男性)。HF的MR患病率为32.7%,有保留EF的HF患者占16.7%,中程EF的HF患者为28.4%,EF降低(HFrEF)的HF患者为49.7%。在具有保留EF的HF组中,多变量logistic回归分析显示,与MR相关的4个因素包括EF(比值比(OR)0.954(0.928-0.981),p=0.001),舒张期左心室后壁厚度(LVPWd)(OR0.274(0.081-0.932),p=0.038),左心房(LA)尺寸(或2.049(1.631-2.576),p<0.001)和年龄(OR1.024(1.007-1.041),p=0.007)。在带中距离EF的HF组中,多变量logistic回归显示,与MR相关的3个因素包括LA维度(OR2.009(1.427-2.829),p<0.001),甘油三酯(TG)(OR0.552(0.359-0.849),p=0.007)和地高辛(OR2.836(1.624-4.951),p<0.001)。在HFrEF组中,多因素logistic回归分析显示,与MR相关的7个因素包括EF(OR0.969(0.949-0.990),p=0.004),(OR0.161(0.067-0.387),p<0.001),LA尺寸(或2.289(1.821-2.878),p<0.001),年龄(OR1.016(1.004-1.027)),p=0.009),TG(OR0.746(0.595-0.936),p=0.011),利尿剂(OR0.559(0.334-0.934),p=0.026)和ICD(OR1.898(1.074-3.354),p=0.027)。
■HF患者的MR负担很高,特别是在HFrEF组中。恶化的心脏结构(LA尺寸和LVPWd)和功能(EF),年龄,医学治疗策略在MR中发挥了重要作用。
UNASSIGNED: Mitral regurgitation (MR) is one of the common complications of heart failure (HF). The prevalence and characteristics of MR are rarely investigated, especially in the Chinese population.
UNASSIGNED: The purpose of this study was to determine the prevalence and characteristics of non-organic MR in HF patients and subgroups defined by ejection fraction.
UNASSIGNED: A single-center, hospital-based, and retrospective chart review study included patients with heart failure admitted to the cardiovascular department from January 2017 to April 2020. Demographic characteristics, laboratory results, and echocardiogram results before discharge were analyzed in different groups defined by left ventricular ejection fraction (EF) using logistic regression and adjusted for confounders.
UNASSIGNED: Finally, 2418 validated HF patients (age 67.2 ± 13.5 years; 68.03% men) were included. The prevalence of MR was 32.7% in HF, 16.7% in HF with preserve EF patients, 28.4% in HF with mid-range EF patients and 49.7% in HF with reduced EF (HFrEF) patients. In the HF with preserved EF group, multivariable logistic regression showed that 4 factors associated with MR including EF (odds ratio (OR) 0.954 (0.928-0.981), p = 0.001), left ventricular posterior wall thickness in diastolic phase (LVPWd) (OR 0.274 (0.081-0.932), p = 0.038), left atrium (LA) dimension (OR 2.049 (1.631-2.576), p < 0.001) and age (OR 1.024 (1.007-1.041), p = 0.007). In the HF with midrange EF group, multivariable logistic regression showed that 3 factors associated with MR including LA dimension (OR 2.009 (1.427-2.829), p < 0.001), triglycerides (TG) (OR 0.552 (0.359-0.849), p = 0.007) and digoxin (OR 2.836 (1.624-4.951), p < 0.001). In the HFrEF group, multivariable logistic regression showed that 7 factors associated with MR including EF (OR 0.969 (0.949-0.990), p = 0.004), (OR 0.161 (0.067-0.387), p < 0.001), LA dimension (OR 2.289 (1.821-2.878), p < 0.001), age (OR 1.016 (1.004-1.027)), p = 0.009), TG (OR 0.746 (0.595-0.936), p = 0.011), diuretics (OR 0.559 (0.334-0.934), p = 0.026) and ICD (OR 1.898 (1.074-3.354), p = 0.027).
UNASSIGNED: HF patients had a high burden of MR, particularly in the HFrEF group. Worsen cardiac structure (LA dimension and LVPWd) and function (EF), age, and medical treatment strategy played essential roles in MR.