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Circulation:肥胖可能是年轻人HFpEF发病率高的主要驱动因素

2018-12-14 国际循环编辑部 国际循环

射血分数保留的心力衰竭(HFpEF),传统上被认为是老年疾病,但也可影响年轻患者。然而,对年轻人的HFpEF知之甚少。Circulation发表的一项最新研究对这一问题进行了探讨。

射血分数保留的心力衰竭(HFpEF),传统上被认为是老年疾病,但也可影响年轻患者。然而,对年轻人的HFpEF知之甚少。Circulation发表的一项最新研究对这一问题进行了探讨。

该研究招募来自11个亚洲地区的1203例HFpEF患者(左心室射血分数≥50%),将其分为非常年轻组(<55岁;n=157),年轻组(55~64岁;n=284),年龄较大组(65~74岁;n=355)和老年组(≥75岁;n=407),并比较不同年龄组患者的临床、超声心动图特征和生活质量,以及非常年轻组HFpEF患者和与之年龄、性别相匹配的无心力衰竭对照组的结局差异。

结果显示,纳入的HFpEF患者中年龄<65岁占37%,较年轻组与男性优势和肥胖患病率较高(体重指数≥30 kg/m2;HFpEF非常年轻组为36%,老年组为16%)相关,肾功能不全、心房颤动和高血压患病率较低(P均<0.001)。在非常年轻和老年HFpEF组,患者左心室充盈压和左心室肥大的患病率相似。进一步分析发现,与老年(21%)HFpEF相比,非常年轻(7%)的患者生活质量更好,1年死亡和心力衰竭住院率更低(P<0.001)。与无心力衰竭的对照组相比,非常年轻的HFpEF患者死亡率高3倍,左心室肥大的患病率是其2倍。

上述结果提示,与没有心力衰竭的对照组相比,年轻和非常年轻的HFpEF患者与老年组表现出类似的心脏不良重构,并且临床结局非常差,而肥胖是年轻和非常年轻的患者HFpEF发病率较高的主要驱动因素。

原始出处:
Jasper Tromp, Michael R. MacDonald, Wan Ting Tay, et al. Heart Failure With Preserved Ejection Fraction in the Young. Circulation. Dec 2018.

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    2019-04-05 feather89
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    2018-12-18 jyzxjiangqin

    肥胖可能是年轻人的影响。

    0

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    2018-12-16 bettycmoon

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