Application value of echocardiography in clinical diagnosis and prognosis evaluation of heart failure with preserved ejection fraction in elderly patients with hypertension
HE Qian1, XU Ke1, YANG Yalan1, ZHOU Chunmei1, LIU Jiakai1, DU Zhenhong2
1. Ultrasound Medicine Department, 416 Hospital of Nuclear Industry/Second Affiliated Hospital of Chengdu Medical College, Chengdu 610057,China; 2. Gastroenterothoracic Surgery Department of 363 Hospital, Chengdu 610041, China
Abstract：Objective To evaluate the application value of echocardiography in clinical diagnosis and prognosis evaluation of heart failure with preserved ejection fraction（HFpEF）in elderly patients with hypertension. Methods A total of 96 elderly hypertension with HFpEF patients who were admitted to the hospital from January 2020 to April 2023 were selected as the study subjects. Among them,patients with HFpEF were included in the study group（n=96）and those without HFpEF were included in the control group（n=100）. The echocardiographic parameters of the two groups were compared,and the clinical value of echocardiography in diagnosing hypertension and HFpEF was analyzed using the receiver operating characteristic（ROC）curve. Patients in the study group were divided into the good prognosis group and the poor prognosis group according to the presence or absence of major adverse cardiovascular events（MACE）within 3 months after discharge. The prognostic factors were explored. Results IVSTD,LVDd,LVPWTD and LVMI in the study group were higher than those in the control group. ROC curve analysis found that the optimal cutoff values of IVSTD,LVDd,LVPWTD and LVMI for diagnosing hypertension and HFpEF were 0.985 mm,4.085 mm,0.965 mm and 114.175 g/m2,respectively. The AUC and sensitivity of the combined diagnosis of hypertension and HFpEF were higher than those of single diagnosis. Hb level and LVEF in the poor prognosis group were lower than those in the good prognosis group. The grade of cardiac function,LVMI and MEE were higher than those in the good prognosis group. Multivariate logistic regression analysis found that Hb,the grade of cardiac function,LVEF,and MEE were independent influencing factors for the prognosis of hypertension and HFpEF. Conclusion Compared with elderly hypertension patients without HFpEF,elderly hypertension with HFpEF patients have larger IVSTD,LVDd,LVPWTD and LVMI. The combination of these four indicators is of high application value in diagnosing hypertension with HFpEF. Hb,the grade of cardiac function,LVEF,and MEE are independent prognostic factors in hypertension with HFpEF patients,which deserves special attention in clinical practice.
何谦, 徐可, 杨雅兰, 周春美, 刘家开, 杜镇鸿. 超声心动图在老年高血压射血分数保留型心力衰竭临床诊断及预后评估中的应用价值[J]. 湖南师范大学学报(医学版), 2023, 20(5): 65-69.
HE Qian, XU Ke, YANG Yalan, ZHOU Chunmei, LIU Jiakai, DU Zhenhong. Application value of echocardiography in clinical diagnosis and prognosis evaluation of heart failure with preserved ejection fraction in elderly patients with hypertension. HuNan ShiFan DaXue XueBao(YiXueBan), 2023, 20(5): 65-69.
2023, Vol. 20 
