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Increased Risk of Congestive Heart Failure Following Carbon Monoxide Poisoning.

一氧化碳中毒后充血性心力衰竭的风险增加。

  • 影响因子:4.83
  • DOI:10.1161/CIRCHEARTFAILURE.120.007267
  • 作者列表:"Huang CC","Chen TH","Ho CH","Chen YC","Hsu CC","Lin HJ","Wang JJ","Chang CP","Guo HR
  • 发表时间:2021-04-01
Abstract

BACKGROUND:Carbon monoxide poisoning (COP) is an important public health issue around the world. It may increase the risk of myocardial injury, but the association between COP and congestive heart failure (CHF) remains unclear. We conducted a study incorporating data from epidemiological and animal studies to clarify this issue. METHODS:Using the National Health Insurance Database of Taiwan, we identified patients with COP diagnosed between 1999 and 2012 and compared them with patients without COP (non-COP cohort) matched by age and the index date at a 1:3 ratio. The comparison for the risk of CHF between the COP and non-COP cohorts was made using Cox proportional hazards regression. We also established a rat model to evaluate cardiac function using echocardiography and studied the pathological changes following COP. RESULTS:The 20 942 patients in the COP cohort had a higher risk for CHF than the 62 826 members in the non-COP cohort after adjusting for sex and underlying comorbidities (adjusted hazard ratio, 2.01 [95% CI, 1.74-2.32]). The increased risk of CHF persisted even after 2 years of follow-up (adjusted hazard ratio, 1.85 [95% CI, 1.55-2.21]). In the animal model, COP led to a decreased left ventricular ejection fraction on echocardiography and damage to cardiac cells with remarkable fibrotic changes. CONCLUSIONS:Our epidemiological data showed an increased risk of CHF was associated with COP, which was supported by the animal study. We suggest close follow-up of cardiac function for patients with COP to facilitate early intervention and further studies to identify other long-term effects that have not been reported in the literature.

摘要

背景: 一氧化碳中毒是世界范围内的重要公共卫生问题。它可能增加心肌损伤的风险,但COP与充血性心力衰竭 (CHF) 之间的关系仍不清楚。我们进行了一项纳入流行病学和动物研究数据的研究,以澄清这一问题。 方法: 使用台湾国家健康保险数据库,我们确定了1999年至2012年间诊断为COP的患者,并将其与年龄和指数日期1:3匹配的无COP患者 (非COP队列) 进行比较。使用Cox比例风险回归对COP和非COP队列之间的CHF风险进行比较。我们还利用超声心动图建立了评价心功能的大鼠模型,并研究了COP后的病理变化。 结果: 在调整了性别和基础合并症后,COP队列中的20-942例患者比非COP队列中的62-826例患者患CHF的风险更高 (调整后的风险比,2.01 [95% CI,1.74-2.32])。即使在2年的随访后,CHF的风险仍然增加 (校正风险比,1.85 [95% CI,1.55-2.21])。在动物模型中,COP导致超声心动图上的左心室射血分数降低和心脏细胞损伤,具有显著的纤维化变化。 结论: 我们的流行病学数据显示CHF的风险增加与COP相关,这得到了动物研究的支持。我们建议对COP患者的心功能进行密切随访,以促进早期干预,并进一步研究以确定文献中尚未报道的其他长期影响。

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