肥胖患者中的主动性心力衰竭筛查：SCORHFE试验的设计、招募和基线特征。
完整摘要 · 中文译文
背景：肥胖与心力衰竭（HF）密切相关，但在初级保健中识别仍具挑战性，因为症状、体征和利钠肽浓度可能难以解读。 目的：描述一项评估在肥胖成人中进行前瞻性多模式心力衰竭筛查的试验的设计、招募、基线特征和可接受性。 方法：年龄45岁及以上、患有肥胖且无已知心脏病的成人按1：1随机分配至前瞻性多模式心力衰竭筛查组或常规护理组。筛查包括病史采集、体格检查、血液采样、12导联心电图和经胸超声心动图。主要终点为1年时左心室功能障碍和/或急性心力衰竭住院。 结果：2024年3月至2025年6月期间，746人表达了兴趣，629人（84.3%）接受了资格评估，420人被随机分组。平均年龄为58.3 ± 8.4岁，295名参与者（70.2%）为女性，中位体重指数为35.0 [32.4-38.0] kg/m²。在385名有腰围数据的参与者中，379人（98.4%）存在中心性肥胖。97名参与者（23.1%）患有两种或两种以上心脏代谢性疾病。在随机抽取的50名接受筛查的参与者中，46人（92.0%）认为筛查时长可接受，47人（94.0%）报告操作负担低，46人（92.0%）支持常规实施。 结论：通过初级保健肥胖路径进行的招募覆盖了具有显著肥胖程度和心脏代谢负担的成人。筛查可接受性较高。 在一个随机子集中。为期一年的随访将确定临床和经济效果。 试验注册号：NCT06137261。
完整摘要 · 英文原文
BACKGROUND: Obesity is strongly associated with heart failure (HF), but recognition remains challenging in primary care because symptoms, physical findings, and natriuretic peptide concentrations may be difficult to interpret. OBJECTIVES: To describe the design, recruitment, baseline characteristics, and acceptability of a trial evaluating proactive multimodal HF screening in adults with obesity. METHODS: Adults aged 45 years or older with obesity and no known cardiac disease were randomized 1:1 to proactive multimodal HF screening or usual care. Screening comprised medical history, physical examination, blood sampling, 12-lead electrocardiography, and transthoracic echocardiography. The primary endpoint is left ventricular dysfunction and/or acute HF hospitalization at 1 year. RESULTS: Between March 2024 and June 2025, 746 individuals expressed interest, 629 (84.3%) underwent eligibility assessment, and 420 were randomized. Mean age was 58.3 ± 8.4 years, 295 participants (70.2%) were women, and median body mass index was 35.0 [32.4-38.0] kg/m2. Among 385 participants with available waist circumference data, 379 (98.4%) had central obesity. Ninety-seven participants (23.1%) had two or more cardiometabolic conditions. Among a random subset of 50 screened participants, 46 (92.0%) considered screening duration acceptable, 47 (94.0%) reported low procedural burden, and 46 (92.0%) supported routine implementation. CONCLUSIONS: Recruitment through primary care obesity pathways reached adults with substantial adiposity and cardiometabolic burden. Screening acceptability was high in a random subset. One-year follow-up will determine clinical and economic effects. TRIAL REGISTRATION NUMBER: NCT06137261.