ESC heart failure · 2020
The ventilatory abnormalities and prognostic values of H2 FPEF score in dyspnoeic patients with preserved left ventricle systolic function.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Huang Wei-Ming, Cheng Hao-Min, Yu Wen-Chung, Guo Chao-Yu, Chiang Chern-En, Chen Chen-Huan, Sung Shih-Hsien
Аннотация
AIMS: Heart failure with preserved ejection fraction (HFpEF) is one of the major diagnoses in dyspnoeic subjects, and H2 FPEF score enables robust differentiation of HFpEF. Given ventilatory abnormalities prevail in subjects with HFpEF, the associations between H2 FPEF score and pulmonary function remain to be elucidated.
METHODS AND RESULTS: Subjects who presented with exertional dyspnoea and had left ventricular ejection fraction of >50% were eligible for this study. Total lung capacity, forced expiratory volume in the 1 s, and forced vital capacity (FVC) were obtained by pulmonary function tests. Pulmonary artery systolic pressure (PASP), the ratio of early ventricular filling flow velocity to the septal mitral annulus tissue velocity (E/e'), and left ventricular mass (LVM) were measured by echocardiogram. Among a total of 5849 participants (65.6 ± 6.4 years, 54% men), 2453 (41.9%) had low H2 FPEF score (0 ~ 1) and 160 (2.7%) had high H2 FPEF score,6~9 respectively. Subjects with high H2 FPEF score were older and had higher proportion of restrictive and obstructive defect, more morbidities, poorer renal function, lower haemoglobin, higher LVM, E/e' ratio, and PASP. During a mean follow-up duration of 30.0 ± 20.5 months, the H2 FPEF score was significantly associated with mortality [hazard ratio and 95% confidence intervals, 1.063(1.010-1.18)], independent of sex, haemoglobin, renal function, LVM, and comorbidities.
CONCLUSIONS: Either obstructive or restrictive ventilation defects prevail in subjects with high H2 FPEF score, indicating chronic obstructive pulmonary disease (COPD) is commonly associated with HFpEF. In addition, H2 FPEF score was correlated with long-term survival in dyspnoeic subjects with or without concomitant diseases of HFpEF and COPD.
METHODS AND RESULTS: Subjects who presented with exertional dyspnoea and had left ventricular ejection fraction of >50% were eligible for this study. Total lung capacity, forced expiratory volume in the 1 s, and forced vital capacity (FVC) were obtained by pulmonary function tests. Pulmonary artery systolic pressure (PASP), the ratio of early ventricular filling flow velocity to the septal mitral annulus tissue velocity (E/e'), and left ventricular mass (LVM) were measured by echocardiogram. Among a total of 5849 participants (65.6 ± 6.4 years, 54% men), 2453 (41.9%) had low H2 FPEF score (0 ~ 1) and 160 (2.7%) had high H2 FPEF score,6~9 respectively. Subjects with high H2 FPEF score were older and had higher proportion of restrictive and obstructive defect, more morbidities, poorer renal function, lower haemoglobin, higher LVM, E/e' ratio, and PASP. During a mean follow-up duration of 30.0 ± 20.5 months, the H2 FPEF score was significantly associated with mortality [hazard ratio and 95% confidence intervals, 1.063(1.010-1.18)], independent of sex, haemoglobin, renal function, LVM, and comorbidities.
CONCLUSIONS: Either obstructive or restrictive ventilation defects prevail in subjects with high H2 FPEF score, indicating chronic obstructive pulmonary disease (COPD) is commonly associated with HFpEF. In addition, H2 FPEF score was correlated with long-term survival in dyspnoeic subjects with or without concomitant diseases of HFpEF and COPD.