【摘要】 目的 :探讨右心房容积指数(RAVI)对慢性收缩性心力衰竭患者临床预后的预测价值。方法 :纳入2012年5月~2013年5月收入我院慢性收缩性心力衰竭患者(左心室射血分数LVEF<40%)120例,采用Simpson法计算RAVI,采用组织多普勒显像评估右心室面积变化率(RVFAC)及三尖瓣峰值收缩速度(Sa)。随访1年,观察记录死亡率、需住院治疗的心衰事件发生率并进行统计学分析。结果 :120例患者完成随访117例,失访3例;其中52例患者达到随访终点。终点事件组较无终点事件组RAVI高,且与LVEF、RVFAC、Sa负相关;RAVI与右心室舒张功能不全不相关。RAVI>29 m L/m2时,ROC曲线下面积为0.89(95%CI为0.82~0.95),敏感性92%,特异性75%。RAVI>29 m L/m2是预测心衰不良事件的独立预测因子。结论 :右心房容积指数可能是慢性收缩性心力衰竭患者预后的独立预测因素。更多还原

【Abstract】 Objective The aim is to study the relationship between the right atrial volume index(RAVI) and prognosis in patients with chronic systolic heart failure(HF). Methods 120 patients with chronic systolic HF and left ventricular ejection fraction(LVEF) <40% were enrolled. The RA volume was calculated by Simpson’s method(RAVI). RV systolic assessment was done using the RV fractional area change(RVFAC), and peak systolic velocity(Sa) using tissue Doppler imaging at the tricuspid annulus. The primary endpoint was death, urgent transplantation, or acute HF episode requiring hospital admission during a follow-up of 1 year. Results Follow up was complete for 117 of 120 patients. Fifty-two patients reached the primary endpoint. The mean RAVI was higher in patients with adverse events, and increased with worsening LVEF, RVFAC, Sa. RAVI was not correlated with estimates of RV diastolic dysfunction. The cut-off threshold for RAVI to predict the primary endpoint using receiver-operating characteristic curve was 29 m L/m2(area under the curve was 0.89%, 95% confidence interval: 0.82~0.95) with a sensitivity of 92%, and a specificity of 75%. NYHA>2, and RAVI were found to be independent predictors of adverse outcome. Conclusion In patients with chronic systolic HF, RAVI is an independent predictor of adverse outcome.更多还原