■急性心力衰竭(AHF)后再住院率归因于持续的血流动力学充血,尽管临床有所改善。心房纵向应变峰值(PALS),利用斑点追踪超声心动图技术,显示AHF后预后的潜力。同时,N-末端激素前体脑钠肽(NT-proBNP)仍然是心内充血的已知生物标志物。
■本研究旨在确定出院前PALS和NT-proBNP作为AHF住院后主要不良心脏事件(MACE)的预测因子之间的关系。
■这项研究是一项前瞻性队列研究,在教授中进行。IG.N.G.Ngoerah医院,巴厘岛,印度尼西亚。
■该研究包括住院的AHF患者,收集人口统计数据,合并症,疗法,出院前进行超声心动图检查。在出院前24h内测定出院前PALS和NT-proBNP。主要结果是MACE,定义为90天内再住院和心血管死亡率。
■对连续变量使用独立t检验(对于具有异常分布的变量使用Mann-WhitneyU检验)和卡方检验进行比较统计分析。用于确定放电前PALS和NT-proBNP的最佳阈值的接收器工作特性(ROC)作为MACE的预测因子。采用Kaplan-Meier曲线来测量这些队列之间的无事件生存差异。然后,使用独立Cox回归确定MACE的预测因子。
■该研究纳入了67例射血分数(EF)变化的患者(16-射血分数保留的心力衰竭,10-心力衰竭,射血分数轻度降低,41-射血分数降低的心力衰竭;平均年龄:56.88±14.57岁)。在90天的随访中,21例患者(31.3%)发生MACE。出院前PALS(曲线下面积[AUC]0.816)和NT-proBNP(AUC0.856)均可作为MACE的预测因子。ROC曲线间AUC差异无统计学意义(面积差异0.039,P=0.553)。回归模型强调出院前PALS和NT-proBNP水平是MACE的独立预测因子。不管EF,平均E/E\',或估计的出院前肺毛细血管楔压。
■出院前PALS与NT-proBNP水平是AHF住院后短期MACE的独立预测因子。
UNASSIGNED: The postacute heart failure (AHF)
rehospitalization rate is attributed to persistent hemodynamic congestion despite clinical improvement. Peak atrial longitudinal strain (PALS), utilizing speckle tracking echocardiography technology, shows potential in post-AHF prognosis. Meanwhile, N-terminal pro-hormone brain natriuretic peptide (NT-proBNP) remains a known biomarker of intracardiac congestion.
UNASSIGNED: This study aimed to determine the relationship between predischarge PALS and NT-proBNP as predictors of major adverse cardiac event (MACE) in patients after AHF hospitalization.
UNASSIGNED: This study is a prospective cohort study, conducted in Prof. Dr. I G.N.G Ngoerah Hospital, Bali, Indonesia.
UNASSIGNED: The study included hospitalized AHF patients, collecting demographic data, comorbidities, therapies, and echocardiographic measures before discharge. Predischarge PALS and NT-proBNP were taken within 24 h before discharge. The main outcome was MACE, defined as
rehospitalization and cardiovascular mortality within 90 days.
UNASSIGNED: Comparative statistical analyses was done using independent t-test for continuous variables (Mann-Whitney U test for variables with abnormal distribution) and Chi-squared tests. Receiver operating characteristic (ROC) used in determining optimal threshold values of predischarge PALS and NT-proBNP as a predictor of MACE. Kaplan-Meier curves were employed to gauge event-free survival differences between these cohorts. Then, independent Cox regression was used to identify the predictors of MACE.
UNASSIGNED: The study enrolled 67 patients with varying ejection fraction (EF) (16 - heart failure with preserved ejection fraction, 10 - heart failure with mildly reduced ejection fraction, and 41 - heart failure with reduced ejection fraction; mean age: 56.88 ± 14.57 years). Over the 90-day follow-up, 21 patients (31.3%) encountered MACE. Both PALS (area under the curve [AUC] 0.816) and NT-proBNP (AUC 0.856) before discharge served as predictors of MACE. There was no significant AUC difference between ROC curves (area difference: 0.039, P = 0.553). The regression model highlighted that PALS and NT-proBNP level before discharge acted as independent predictors of MACE, irrespective of EF, average E/e\', or estimated predischarge pulmonary capillary wedge pressure.
UNASSIGNED: Predischarge PALS is comparable to NT-proBNP levels as independent predictors of short-term MACE after AHF hospitalization.