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当前位置：老年医学与慢性病管理 > 2026年 1卷 (1)期

Open Access Article

Geriatric Medicine and Chronic Disease Management. 2026; 1: (1) ; 35-45 ; DOI: 10.12208/j.gmcdm.20260005.

Prognostic significance of the “frailty syndrome” in elderly patients with diastolic dysfunction and heart failure with preserved ejection fraction
舒张功能障碍和射血分数保留的心力衰竭老年患者“虚弱综合征”的预后意义

作者： Lidija Veterovska Miljkovic *

老年科和姑息医学专科医院北马其顿斯科普里

*通讯作者： Lidija Veterovska Miljkovic,单位：老年科和姑息医学专科医院北马其顿斯科普里；

发布时间: 2026-06-29 总浏览量: 146 下载量: 加载中...

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摘要

目的近年来，人们对了解老年心血管疾病患者中普遍存在的恶病质、肌肉萎缩和身体虚弱现象的兴趣日益浓厚。这种兴趣最初源于心力衰竭（HF）领域。此外，“虚弱综合征”（FS）会导致心力衰竭患者死亡率和住院率升高，生活质量下降。旨在确定老年人群中虚弱综合征的关联程度及其在舒张功能障碍（DD）和射血分数保留型心力衰竭中的预后价值。方法在斯科普里“11月13日”老年及姑息治疗专科医院，对132名年龄≥65岁且至少具有一项心血管危险因素的患者进行了前瞻性研究。采用格罗宁根虚弱指数（GFI问卷）评估虚弱程度。根据欧洲/美国心脏病学会和超声心动图学会的最新指南，通过经胸超声心动图评估舒张功能障碍和心力衰竭的程度。结果患者年龄对虚弱程度有显著影响，虚弱患者的年龄显著高于非虚弱患者。在合并症方面，非虚弱、中度虚弱和重度虚弱患者在高血压、血脂异常和心肌梗死的发生率方面无显著差异，但在卒中、心力衰竭和糖尿病的发生率方面存在显著差异。虚弱程度与较大的左心房容积、较低的左心室射血分数和较高的舒张功能障碍程度相关。在12个月的研究期间，研究组中有15例患者（19.8%）发生了新的心血管事件和死亡，所有这些患者均具有较高的虚弱程度，且虚弱程度与舒张功能障碍程度和心力衰竭程度显著相关。结论在射血分数保留型心力衰竭老年患者中，虚弱程度和舒张功能障碍程度彼此显著相关，且与未来心血管事件和死亡显著相关。

关键词： 舒张功能；老年患者；衰弱综合征

Abstract

Objectives The last several years have seen increasing interest in understanding cachexia, muscle wasting, and physical frailty across the broad spectrum of old patients with cardiovascular illnesses. This interest originally started in the field of heart failure (HF). Moreover, “frailty syndrome” (FS) contributes to increased mortality and hospitalization and reduced quality of life in HF. To determine the degree of association of the FS and its prognostic utility in diastolic dysfunction (DD) and heart failure with preserved ejection fraction in an elderly population.
Methods One hundred and thirty-two patients ≥ 65 years of age who had at least one cardiovascular risk factor were prospectively examined at the Specialized Hospital for Geriatric and Palliative Medicine “13th November” - Skopje. The degree of frailty was determined with the Groningen Frailty Index (GFI questionnaire). DD and the degree of HF were determined by transthoracic echocardiography according to the latest recommendations of the European/American Society of Cardiology and Echocardiography.
Results Patients’ age had a significant effect on the degree of frailty, with frail patients being significantly older than patients without frailty. Regarding the comorbidities present, patients without frailty, moderately frail, and marked frail did not differ significantly in terms of the frequency of hypertension, dyslipidemia, and myocardial infarction, while they differed significantly in regarding the frequency of stroke, heart failure, and diabetes mellitus. FS was associated with a larger left atrial volume, a lower left ventricular ejection fraction, and a higher degree of DD. During the 12-month period, 15 patients (19.8%) of the study group had a new cardiovascular event and death, all of whom had a high degree of FS, which significantly correlated with the degree of DD and HF.
Conclusion s FS and the degree of DD were significantly correlated with each other and with future cardiovascular events and death in an elderly population with heart failure with preserved ejection fraction.

Key words： Diastolic function; Elderly patient; Frailty syndrome

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引用本文

LidijaVeterovskaMiljkovic, 舒张功能障碍和射血分数保留的心力衰竭老年患者“虚弱综合征”的预后意义[J]. 老年医学与慢性病管理, 2026; 1: (1) : 35-45.

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