H2FPEF和HFA-PEFF评分在我国射血分数保留心力衰竭及射血分数保留心力衰竭合并心房颤动患者中的适用性分析OA北大核心CSTPCDMEDLINE
Applicability of H2 FPEF and HFA-PEFF Scores in Chinese Patients Suffering From Heart Failure With Preserved Ejection Fraction and Heart Failure With Preserved Ejection Fraction Complicated With Atrial Fibrillation
目的 分析H2FPEF和HFA-PEFF评分对我国单纯射血分数保留的心力衰竭(HFpEF)和HFpEF合并心房颤动(AF)的诊断价值,并探讨其相关因素.方法 本研究为横断面研究,连续纳入 2009 至 2020 年兰州大学第一医院老年心血管内科收治的HFpEF患者 835 例,根据是否合并AF分为HFpEF合并AF组(n =267)和单纯HFpEF组(n =568);采用HFA-PEFF和H2FPEF评分进行回顾性诊断,并评估两种评分系统诊断的一致性.选取同期136 名年龄、性别分别与观察组频数匹配的健康人作为健康对照组,分别对HFpEF合并AF 和单纯HFpEF进行受试者工作特征曲线分析,评估H2FPEF和HFA-PEFF两种评分识别HFpEF合并AF 和单纯HFpEF 的能力.结果 HFpEF合并AF组和单纯HFpEF组HFA-PEFF评分比较差异无统计学意义(P =0.070),但HFpEF合并AF组平均H2FPEF评分和评分≥6 分的比例均明显高于单纯HFpEF组(P均<0.001).受试者工作特征曲线分析显示,HFA-PEFF和H2FPEF评分诊断全部HFpEF患者的效能均较高,受试者工作特征曲线下面积(AUC)分别为0.892 和0.922,最佳临界值均为4.HFA-PEFF评分诊断单纯HF-pEF和HFpEF合并AF的效能接近,AUC分别为0.899 和0.911.H2FPEF 评分诊断HFpEF合并AF的效能较高,AUC约为1.000,而诊断单纯HFpEF的价值相对较低,AUC为0.885.结论 HFA-PEFF评分在单纯HFpEF和HFpEF合并AF中均具有较高的适应性,但H2FPEF评分可能低估了我国患者的单纯HFpEF,H2FPEF评分在我国单纯HFpEF患者中的适用性有待进一步研究.
Objective To analyze the diagnostic values of H2FPEF and HFA-PEFF scores for heart failure with preserved ejection fraction(HFpEF)and HFpEF complicated with atrial fibrillation(HFpEF-AF)in Chinese patients and explore the related factors.Methods A cross-sectional study was conducted.A total of 835 consecutive HFpEF patients treated in the Department of Geriatric Cardiology,the First Hospital of Lanzhou Uni-versity from 2009 to 2020 were selected and assigned to a HFpEF-AF group(n =267)and a HFpEF group(n = 568)according to the presence of AF or not.HFA-PEFF and H2FPEF scores were used for retrospective diagnosis and the diagnostic consistency of the two scores was assessed.One hundred and thirty-six healthy volunteers with age and sex matching the patients during the same period were selected as healthy controls.The receiver operating characteristic(ROC)curves were established for H2FPEF and HFA-PEFF scores in diagnosing HFpEF-AF and HFpEF,on the basis of which the diagnostic performance of the two scores was evaluated.Results There was no difference in the HFA-PEFF score between the two groups(P =0.070).However,the HFpEF-AF group had higher mean H2FPEF score and higher proportion of patients with the score no less than 6 than the HFpEF group(P<0.001).According to the ROC curves,HFA-PEFF and H2FPEF scores demonstrated high perform-ance in diagnosing all HFpEF patients,with the area under the curve(AUC)of 0.892 and 0.922 and the opti-mal cut-offs of 4 and 4,respectively.The HFA-PEFF score showed similar performance in diagnosing HFpEF and HFpEF-AF,with the AUC of 0.899 and 0.911,respectively.The H2FPEF score had higher performance in di-agnosing HFpEF-AF(AUC of approximately 1.000)and low performance in diagnosing HFpEF(AUC of 0.885).Conclusions The HFA-PEFF score is applicable in the diagnosis of both HFpEF and HFpEF-AF.The H2FPEF score may underestimate HFpEF in Chinese patients,and its applicability in the Chinese patients with HFpEF alone remains to be investigated.
贾晓艳;刘离香;王东伟;马西文;刘永铭
郑州大学附属郑州中心医院病案管理科, 郑州 450007兰州大学第一医院老年心血管科 甘肃省老年疾病临床医学研究中心, 兰州 730000郑州大学附属郑州中心医院 心脏康复科, 郑州 450007郑州大学附属郑州中心医院 老年医学科, 郑州 450007
临床医学
射血分数保留的心力衰竭心房颤动H2FPEF评分HFA-PEFF评分
heart failure with preserved ejection fractionatrial fibrillationH2 FPEF scoreHFA-PEFF score
《中国医学科学院学报》 2024 (002)
154-160 / 7
甘肃省重点研发计划(20YF8FA079)
评论