CAJ | 학술논문

目的分析扩张型心肌病(DCM)患者左心室射血分数(LVEF)及舒张末期内径(LVEDD)恢复正常的发生率及其预测因素.方法连续入选2008年10月至2012年10月住院的DCM患者296例,随访至少12个月或至全因死亡及心脏移植.根据复查超声心动图结果,定义LVEF≥50％及LVEDD≤55 mm(男)或50 mm(女)为恢复正常标准.调查其发生率并分析预测因素.结果 296例DCM患者纳入本研究,中位随访时间28个月,27.4％ (81/296)的患者LVEF恢复正常,21.3％ (63/296)的患者LVEDD恢复正常,17.6％ (52/296)的患者两者均恢复正常.在两者均恢复的患者中,LVEF由(31.7±6.3)％增加至(57.5±5.2)％(P＜0.01),LVEDD由(62.7±4.3)mm减小至(50.2±3.7) mm(P ＜0.01).多变量logistic回归分析结果显示,心力衰竭病史短(OR=0.983,P＜0.01)、入院收缩压高(OR=1.036,P＜0.01)、基线LVEDD小(OR=0.898,P＜0.01)及LVEF高(OR=1.073,P＜0.05)与DCM患者LVEF及LVEDD均恢复正常相关.结论部分DCM患者经过标准抗心力衰竭治疗后,LVEF及LVEDD均可恢复正常.心力衰竭病史短、入院收缩压高、基线LVEDD小或LVEF高的患者恢复的可能性大.
목적 분석확장형심기병(DCM)환자좌심실사혈분수(LVEF)급서장말기내경(LVEDD)회복정상적발생솔급기예측인소.방법 련속입선2008년10월지2012년10월주원적DCM환자296례,수방지소12개월혹지전인사망급심장이식.근거복사초성심동도결과,정의LVEF≥50％급LVEDD≤55 mm(남)혹50 mm(녀)위회복정상표준.조사기발생솔병분석예측인소.결과 296례DCM환자납입본연구,중위수방시간28개월,27.4％ (81/296)적환자LVEF회복정상,21.3％ (63/296)적환자LVEDD회복정상,17.6％ (52/296)적환자량자균회복정상.재량자균회복적환자중,LVEF유(31.7±6.3)％증가지(57.5±5.2)％(P＜0.01),LVEDD유(62.7±4.3)mm감소지(50.2±3.7) mm(P ＜0.01).다변량logistic회귀분석결과현시,심력쇠갈병사단(OR=0.983,P＜0.01)、입원수축압고(OR=1.036,P＜0.01)、기선LVEDD소(OR=0.898,P＜0.01)급LVEF고(OR=1.073,P＜0.05)여DCM환자LVEF급LVEDD균회복정상상관.결론 부분DCM환자경과표준항심력쇠갈치료후,LVEF급LVEDD균가회복정상.심력쇠갈병사단、입원수축압고、기선LVEDD소혹LVEF고적환자회복적가능성대.
Objective To observe the frequency and predictors of recovery of normal left ventricular ejection fraction (LVEF) and end-diastolic diameter (LVEDD) in patients with dilated cardiomyopathy (DCM).Methods A consecutive cohort of 296 patients with DCM were reviewed and followed up for at least 12 months or to death or cardiac transplantation,to identify those with recovery of normal LVEF,defined as LVEF ≥ 50％,or recovery of normal LVEDD,defined as LVEDD ≤ 55/50 mm for male/female,or both by follow up echocardiography.Variables regarded as potentially relevant to left ventricular function and dimension recovery were evaluated to identify predictors using multivariable logistic regression analysis.Results After a median follow-up of 28 months,normal LVEF was evidenced in 81 patients (27.4％),normal LVEDD was found in 63 patients (21.3％) and both parameters were recovered in 52 patients (17.6％),LVEF was increased from (31.7 ±6.3)％ to (57.5 ±5.2)％ (P ＜0.01) and LVEDD decreased from (62.7 ± 4.3) mm to (50.2 ± 3.7) mm (P ＜ 0.01) in these 52 patients.Multivariable logistic regression analysis showed that shorter symptom duration,higher systolic blood pressure at admission,smaller LVEDD and lower LVEF by echocardiography at baseline were independent predictors of subsequent recovery of normal LVEF and LVEDD.Conclusion Current therapy for heart failure could lead to recovery of normal LVEF and LVEDD in part of DCM patients,especially for DCM patients with short symptom duration,higher systolic blood pressure at admission,less enlarged LVEDD and less reduced LVEF at baseline echocardiography.