大動脈狭窄のために大動脈弁置換手術を受ける患者の左心室内腔内流の異常加速. 高い術後の罹患率と死亡率のマーカーである
G Aurigemma1, S Battista, D Orsinelli
1Noninvasive Laboratory, University of Massachusetts Medical Center, Worcester 01655.
Circulation
|September 1, 1992
まとめ
大動脈静脈狭窄のために大動脈弁の置換後に異常な内腔内流の加速は,より高いリスクを示しています. この発見はドップラーエコーカルディオグラフィで特定され,患者の死亡率と罹病率の増加と関連しています.
科学分野:
- 心臓病学 心臓病学
- エコーカルディオグラフィー エコーカルディオグラフィー
- 心臓外科手術について
背景:
- 大動脈狭窄は,一般的な弁性心疾患です.
- 大動脈弁置換 (AVR) は重度の大動脈狭窄症の標準的な治療法です.
- AVRの結果の術後の評価は極めて重要です.
研究 の 目的:
- AVR後の異常な内腔内流の加速度を有する患者の臨床およびエコーカルディオグラフィの特徴を調査する.
- この発見と術後の結果との関連を判断する.
主な方法:
- 大動脈狭窄のためにAVRを受けた53人の患者の遡及的レビュー.
- 術後のドップラーエコーカルディオグラフィーで,内腔内血流の評価を行う.
- 異常な流れ加速を患った患者と無患患者の比較.
主要な成果:
- 13人の患者 (グループ1) が異常な内腔内流の加速を示した (平均グラデント104.6mmHg).
- グループ1は,異なる心室幾何学 (高縮,より小さな穴,より高い射出分数) を有していた.
- 1グループでは,手術後の死亡率 (38%対12%) と罹患率が高くなりました.
結論:
- AVR後の異常な内腔内流の加速は,特定の心室幾何学と超正常な機能と関連しています.
- この発見は,手術後の罹患率と死亡率の増加のマーカーとして機能します.
- ドップラーエコーカルディオグラフィは,リスクの階層化と治療のガイドラインに役立ちます.
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