■射血分数(EF)由于其比较简单而被广泛用于评估心力衰竭(HF)期间的心功能,但在心室肥大期间可能会歪曲心功能,尤其是在保留EF(HFpEF)的心力衰竭中。为了解决这个缺点,我们评估EF的校正因子,这相当于在中间壁层(不需要中间层识别)而不是在心内膜表面计算EF,从而更好地补充其他复杂的指标。
■研究了回顾性队列数据,由2,752个人组成(男性占56.5%,年龄69.3±16.4岁),要求进行肌钙蛋白测试并接受超声心动图检查,作为其在三个中心的临床评估的一部分。构建Cox比例回归模型,以比较校正EF(EFa)与EF评估心力衰竭入院风险。
■比较HFpEF患者与非HF患者,EF没有显着差异(62.3±7.6%与64.2±6.2%,p=0.79),但EFa有显著差异(56.6±6.4%与61.8±9.9%,p=0.0007)。低EF和低EFa均与高HF再入院风险相关。然而,在EF正常(EF≥50%)的队列中,使用EFa的模型与3年内的HF再入院明显更相关,其中遗漏一个交叉验证ROC分析显示错误减少了18.6%,净分类指数(NRI)分析表明,事件的风险增量分类增加了12.2%,而非事件的风险递减分类下降了16.6%。
■EFa与EF正常患者的HF再入院相关。
UNASSIGNED: Ejection fraction (EF) is widely used to evaluate heart function during heart failure (HF) due to its simplicity compared but it may misrepresent cardiac function during ventricular hypertrophy, especially in heart failure with preserved EF (HFpEF). To resolve this shortcoming, we evaluate a correction factor to EF, which is equivalent to computing EF at the mid-wall layer (without the need for mid-layer identification) rather than at the endocardial surface, and thus better complements other complex metrics.
UNASSIGNED: The retrospective cohort data was studied, consisting of 2,752 individuals (56.5% male, age 69.3 ± 16.4 years) admitted with a request of a troponin test and undergoing echocardiography as part of their clinical assessment across three centres. Cox-proportional regression models were constructed to compare the adjusted EF (EFa) to EF in evaluating risk of heart failure admissions.
UNASSIGNED: Comparing HFpEF patients to non-HF cases, there was no significant difference in EF (62.3 ± 7.6% vs. 64.2 ± 6.2%, p = 0.79), but there was a significant difference in EFa (56.6 ± 6.4% vs. 61.8 ± 9.9%, p = 0.0007). Both low EF and low EFa were associated with a high HF readmission risk. However, in the cohort with a normal EF (EF ≥ 50%), models using EFa were significantly more associative with HF readmissions within 3 years, where the leave one out cross validation ROC analysis showed a 18.6% reduction in errors, and Net Classification Index (NRI) analysis showed that risk increment classification of events increased by 12.2%, while risk decrement classification of non-events decreased by 16.6%.
UNASSIGNED: EFa is associated with HF readmission in patients with a normal EF.