舒张性心力衰竭的超声心动图评价及其诊治现状_汪芳.pptVIP

* * 071016a_Irbe GLB.IRB.07.10.11 Mortality in patients with heart failure with preserved systolic function In a recent multicentre study in Canada, Bhatia et al evaluated 2,802 patients admitted to 103 hospitals from April 1999 through March 2001. Patients were categorised into those patients with an ejection fraction of 40% (heart failure with reduced ejection fraction, n=1570), those with borderline ejection fraction of ≥40-50% (n=352), and those with an ejection fraction of 50% (heart failure with preserved ejection fraction, n= 880). They presented the data for the first and last groups to provide a more distinct comparison of groups.2 For patients with heart failure with reduced ejection fraction (HF-REF), mortality rates at 1 year were 25.5%, compared with 22.2% for patients with heart failure with preserved systolic function (HF-PSF) (P=0.07). Even after adjustment for other significant predictors, the mortality rates were not significantly different between the two groups.2 In another recent study Owan, et al evaluated 4,596 patients who had data on ejection fraction and a discharge diagnosis of heart failure from 1987 through 2001 at the Mayo Clinic Hospitals in Olmstead County, Minnesota, USA.1 Patients with an ejection fraction of 50% were classified as having heart failure with preserved ejection fraction (n=2,167) versus those with an ejection fraction of less than 50%, classified as having heart failure with reduced ejection fraction (n= 2,429).1 The survival rate was higher among patients with preserved systolic function (HF-PSF) compared with those with reduced ejection fraction (HF-REF), although the difference was small; mortality rates were 29% and 32% at one year and 65% and 68% at 5 years, respectively. After adjustment for differences in baseline characteristics, the likelihood of survival was still slightly higher among patients with preserved systolic function (hazard ratio for death, 0.96; 95% confidence interval, 0.92 to 1.00) Reference