发表在欧洲心脏病学杂志上的一份研究报告指出：老龄、男性、入院时的低收缩压、C—反应蛋白升高以及肾功能不全都是急性心力衰竭（AHF）的独立危险因素。
芬兰赫尔辛基大学中心医院的Veli-Pekka Harjola医生及其同事们进行了一项前瞻性多中心研究，受试的620名患者都因急性心力衰竭入院，平均年龄75.1岁，半数为男性。这项名为芬兰急性心衰研究的项目是第一次根据欧洲心脏病学会标准定义并观察连续心力衰竭的患者，不同于以往采用的欧洲心衰调查定义。
该研究中约一半的受试者患者为新发心衰，最常见的临床表现为急性充血和肺水肿是，发生率分别为63.5%和26.3%。三分之二的患者左心室射学分数（LVEF）≥45%，其中半数的患者储备收缩功能尚存。在出院的时，86%的患者服用β受体阻滞剂，而76%的患者服用ACE抑制剂或者血管紧张素受体拮抗剂。在为期12个月的随访中，发现总的全因死亡率为27.4%，并且失代偿性充血性心力衰竭组为33.5%，高于新发心衰组。
对研究结果进一步的分析得出的结论是：老龄、男性、入院低收缩压、血肌酐升高等都是AHF的独立预后因素。
另外研究人员指出，对于AHF更好的理解可有助于设计出临床试验方法，以改善AHF患者预后的，但本试验仅仅是将AHF作为一个对立的实体进行的研究，下一步研究还需要考虑各种不同病因和临床表现。
Risk factors for acute heart failure described
22 December 2006
Independent risk factors for the development of acute heart failure (AHF) include age, male gender, lower systolic blood pressure on admission to hospital, elevated C-reactive protein, and renal dysfunction, research aimed at characterizing the condition reveals.
The Finnish Acute Heart Failure Study (FINN-AKVA) describes the first population of consecutive AHF patients defined according to the European Society of Cardiology criteria, as distinct to the Euro Heart Failure Survey.
Veli-Pekka Harjola (Helsinki University Central Hospital, Finland) and colleagues conducted a prospective multicenter study of 620 patients hospitalized due to AHF, with a mean age of 75.1 years, half of whom were men.
Half of the patients had new-onset HF, while acute congestion and pulmonary edema were the most common clinical presentations, in 63.5%, and 26.3%, respectively.
Left ventricular ejection fraction (LVEF) was reported in two thirds of the group, among whom half had preserved systolic function, defined LVEF≥45%.
At discharge, 86% of patients were receiving beta blockers and 76% were receiving either ACE inhibitors of angiotensin receptor blockers.
The 12-month all-cause mortality was 27.4%, and was higher among those with decompensated congestive HF (33.5%) than the de novo HF group.
Further analysis showed that older age (hazard ratio [HR] per 10-year increase=1.6, p<0.0001), male gender (HR=1.5, p=0.04, lower SBP on admission (HR per 10 mmHg increase=0.9, p=0.0003), CRP >10 mg/l (HR=1.9, p=0.0005), and creatinine >120 µmol/l (HR=1.9, p=0.00009) were independent prognostic indicators of AHF.
"Better understanding of AHF may help develop protocols for trials to improve prognosis of patients with AHF," the authors say.
"Indeed," they add, "in contrast to studying AHF as a single entity, more refined trials, which take into account diverse etiologies and manifestations of AHF, are needed."
Eur Heart J 2006; 27: 3011-3017
http://www.incirculation.net/NewsItem/Risk-factors-for-acute-heart-failure-described.aspx
编辑：蓝色幻想
