摘要
目的 筛选可预测顽固性高血压(RH)患者预后的超声心动图心肌做功指标.方法 前瞻性纳入67例RH患者,采集超声心动图基线数据;随访至其后4年或发生不良事件时;比较不良事件组与无不良事件组基线超声指标,筛选预测RH患者发生不良事件的心肌做功指标.结果 随访期间3例失访,21例发生(A组)、43例未发生(B组)不良事件.A组左心室壁增厚占比及整体无用功(GWW)均高于,而左心室整体纵向应变(LVGLS)、整体做功效率均低于B组(P均＜0.05).左心室壁增厚是RH患者发生不良事件的独立危险因素(OR=6.96,P＜0.05;HR=5.026,P＜0.05).以一14.50％、109.00 mmHg％及12 mm为LVGLS、GWW及左心室壁增厚的临界值,其预测RH患者发生不良事件的曲线下面积(AUC)分别为0.791、0.732及0.664,三者联合AUC为0.857,优于单一 GWW及左心室壁增厚(P均＜0.05).结论 根据LVGLS、GWW及左心室壁厚度可较好地预测RH患者发生不良事件.
Abstract
Objective To screen echocardiography myocardial work indicators for predicting prognosis of patients with resistant hypertension(RH).Methods Totally 67 RH patients were prospectively enrolled,and baseline echocardiography data were collected.Follow-up was conducted until 4 years after examination or when adverse events occurred.The baseline data were compared between those with adverse event(group A)and without adverse events(group B),and the myocardial work indicators able to be used to predict adverse events in RH patients were screened.Results During follow-up period,3 cases were lost,21 cases had and 43 cases did not had adverse events.The proportion of left ventricular wall thickening and global wasted work(GWW)in group A were both higher,while the left ventricular global longitudinal strain(LVGLS)and the global work efficiency in group A were both lower than those in group B(all P＜0.05).Left ventricular wall thickening was an independent risk factor for adverse events in RH patients(OR=6.96,P＜0.05;HR=5.026,P＜0.05).Taken-14.50％,109.00 mmHg％and 12 mm as the cutoff value,respectively,the area under the curve(AUC)of LVGLS,GWW and left ventricular wall thickening for predicting adverse events in RH patients was 0.791,0.732 and 0.664,respectively,of the combination of the above three was 0.857,and the latter was superior to AUC of GWW and left ventricular wall thickening(both P＜0.05).Conclusion LVGLS,GWW and thickness of left ventricular wall could be used to predict adverse events in RH patients.
基金项目
厦门市医疗卫生指导性项目(3502Z20224ZD1091)
维普
万方数据