心室长轴（收缩）功能与心衰患者远期生存率密切相关

yuji8

ABSTRACT
摘要
Objective: To assess the importance of ventricular systolic and diastolic long-axis (LAX) function in comparison with short-axis (SAX) function for prediction of long-term survival in patients with heart failure.
目的：与心室短轴(SAX)功能比较，评估心室长轴(LAX)收缩和舒张功能预测心衰患者远期生存率的价值。
Design: Prospective epidemiological study.
设计：前瞻性流行病学调查。
Setting: University and county hospital.
执行单位：大学和郡医院
Patients and methods: Patients with idiopathic heart failure (n = 228), not older than 65 years, mean (SD) ejection fraction 44 (17)%, were investigated with echocardiography in the SAX and in the LAX basal parts of the right and left ventricle. Patients were followed up for 10 years with respect to total survival or heart transplantation.
对象和方法：原发性心力衰竭患者228例，年龄《65岁，平均（标准差）射血分数44（17）％，经左、右心室基底部短轴和长轴超声心动图测量。就总生存率或心脏移植指标随访10年。
Results: Left ventricular (LV) LAX systolic amplitude was a strong risk predictor of long-term survival (p<0.001). In a multivariate Cox proportional hazard analysis, adjusting for age, gender, heart rate, systolic blood pressure, and SAX fractional shortening, LAX systolic amplitude was the only independent predictor of outcome (hazard ratio = 0.89 (95% CI 0.80 to 0.98), p = 0.02). Survival curves for each quartile of LAX systolic amplitude differentiated between mild, moderate and severe dysfunction in relation to outcome (p<0.001). There was a significant correlation between SAX and LAX ventricular function only in the lower range of LAX systolic amplitude (<6.8 mm).
结果：左室（LV）长轴收缩幅度是（该人群）远期生存率的强危险性预测因子(P值<0.001)。采用Cox多因素风险模型分析，校正年龄、性别、心率、收缩压和短轴缩短率后，长轴收缩幅度是预后的唯一独立预测因子（危险比＝0.89（95% 置信区间 0.80－0.98），P值＝0.02）。长轴收缩幅度四分位数生存曲线就与事件的相关性划分为轻度、中度和重度异常（这句怎么翻译？）(P值<0.001)。短轴与长轴心室功能在长轴收缩幅度〈6.8mm范围内有显著关联。
Conclusions: LV LAX systolic amplitude independently predicted survival, after adjustment for clinical variables and LV SAX function. These data further emphasise the importance of the basal parts of the ventricles for ventricular function and thereby long-term outcome.
结论：在校正临床变量和左室短轴功能后，左室长轴收缩幅度独立预测生存率。这些数据进一步强调，经心室基底部心室功能评估与远期预后的重要性。
Heart 2008;94:284-289
http://heart.bmj.com/cgi/content/abstract/94/3/284