E/e’比值与射血分数改善型心衰患者预后的相关性研究

A Study on the Correlation between E/e’ Ratio and Prognosis in Heart Failure Patients with Improved Ejection Fraction

摘要: 目的：探讨E/e’比值在射血分数改善型心力衰竭(HFimpEF)患者中的预后价值。方法：收集2019年1月~2022年1月因HFrEF在青岛大学附属医院心血管内科住院的患者。根据心力衰竭类型的不同，将患者分为HFrEF组(LVEF ≤ 40%, 120例)和HFimpEF组(LVEF > 40%, 104例)。收集患者的一般临床资料、化验和超声心动图结果、治疗情况。随访统计患者心衰再住院及全因死亡的复合终点事件。结果：共纳入患者224例，平均年龄70.56 ± 9.67岁，女性73例(32.6%)；HFrEF组120例(53.6%)，HFimpEF组104例(46.4%)。入院时，两组患者LVEF差异无统计学意义(P > 0.05)。HFrEF组e’较HFimpEF组小，E/e’、左室舒张末内径、左室收缩末内径较HFimpEF组大(P均 < 0.05)。1年随访时HFimpEF组LVEF、e’较HFrEF组大，E/e’、左室舒张末内径、左室收缩末内径较HFrEF组小(P均 < 0.05)。HFimpEF组心衰再住院及全因死亡的复合终点事件低于HFrEF组(P < 0.001)。在HFimpEF患者中，当E/e’ > 10.6 (Log-Rank P = 0.014)时，心衰再住院及全因死亡复合终点发生率显著增加。结论：E/e’比值与HFimpEF患者预后相关，可作为HFimpEF患者预后的独立预测因子。高E/e’比值的HFimpEF患者心衰再住院及全因死亡的复合终点发生率显著增加。因此，临床上要重点关注此类患者。

Abstract: Objective: To investigate the prognostic value of E/e’ ratio in FHFimpEF. Methods: Patients hospi-talized for HFrEF in the Department of Cardiology of the Affiliated Hospital of Qingdao University from January 2019 to January 2022 were collected. According to the different types of heart failure, the patients were divided into HFrEF group (LVEF ≤ 40%, 120 cases) and HFimpEF group (LVEF > 40%, 104 cases). The general clinical data, laboratory and echocardiographic results, and treatment of the patients were collected. Patients were followed up for the composite endpoint events of heart failure rehospitalization and all-cause death. Results: A total of 224 patients were enrolled, with an average age of 70.56 ± 9.67 years and 73 (32.6%) were female. There were 120 patients (53.6%) with HFrEF and 104 patients (46.4%) with HFimpEF. At admission, there was no significant differ-ence in LVEF between the two groups (P > 0.05). In HFrEF group, e’ was smaller than that in HFimpEF group, while E/e’, left ventricular end-diastolic diameter and left ventricular end-systolic diameter were larger than those in HFimpEF group (all P < 0.05). At 1-year follow-up, LVEF and e’ in HFimpEF group were higher than those in HFrEF group, and E/e’, left ventricular end-diastolic di-ameter and left ventricular end-systolic diameter were lower than those in HFrEF group (all P < 0.05). The composite endpoint events of rehospitalization for heart failure and all-cause death were significantly lower in the HFimpEF group than in the HFrEF group (P < 0.001). In HFimpEF patients, when E/e’ > 10.6 (log-Rank P = 0.014), the composite endpoint of HF rehospitalization and all-cause death were significantly increased. Conclusions: The E/e’ ratio is associated with the prognosis of patients with HFimpEF, and can be used as an independent predictor of the prognosis of patients with HFimpEF. The composite endpoint of HF rehospitalization and all-cause death were signifi-cantly increased in HFimpEF patients with high E/e’ ratio. Therefore, clinical attention should be paid to such patients.