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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。
Objective: To investigate the predictive value of right atrial volume index (RAVI) in clinical prognosis of patients with chronic systolic heart failure. Methods: A total of 120 patients with chronic systolic heart failure (LVEF <40%) admitted to our hospital from May 2012 to May 2013 were included in this study. RAVI was calculated by Simpson’s method and tissue right ventricular mass index Ventricular area change rate (RVFAC) and tricuspid peak systolic velocity (Sa). Followed up for 1 year, observed the mortality rate, the incidence of heart failure requiring hospitalization and statistical analysis. Results: Of the 120 patients, 117 were followed up and 3 were lost to follow-up. Among them, 52 patients reached the end of follow-up. The end point event group was higher than the end point event group RAVI, and negatively correlated with LVEF, RVFAC, Sa; RAVI was not correlated with right ventricular diastolic dysfunction. The area under the ROC curve for RAVI> 29 m L / m 2 was 0.89 (95% CI 0.82 to 0.95) with a sensitivity of 92% and a specificity of 75%. RAVI> 29 m L / m2 is an independent predictor of adverse events in the prediction of heart failure. Conclusion: Right atrial volume index may be an independent predictor of prognosis in patients with chronic systolic heart failure.