,在高血压、糖尿病和冠心病病史上也类似,因此,也许可以用不同研究中患者的病情轻重不同来解释。
此外,舒张性心衰的预后和基础疾病有关。冠心病患者,特别是老龄冠心病患者,预后差。如Aronow等[33]对166例平均年龄82岁的冠心病患者研究,发现他们1年、2年、3年和4年的死亡率分别为22%、38%、46%和56%。而在没有冠心病的患者,舒张性心力衰竭的预后要好得多。如Zile[34]对左室肥厚的患者研究,发现其年死亡率仅为2%;Brogen[35]对53例经心导管证实无冠心病和瓣膜病的患者研究,平均随访68月,仅有1例心源性死亡,这些患者中有高血压病史者83%,有糖尿病史者30%,15%患者有左室肥厚。显然,在没有明显心肌缺血和显著左室肥厚的患者,舒张性心衰的预后还不是很差。
这些资料表明,舒张性心衰的预后有很大的差异,临床应根据具体患者的病情讨论他们的预后,并采取相应的措施。
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