暗号性脳卒中,左心房機能,心房動:複雑な関係
Francesca Augusta Gabrielli1, Gianluigi Bencardino2, Antonio Di Renzo3
1Cardiology Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. francescaaugusta.gabrielli@policlinicogemelli.it.
まとめ
左心房体積指数 (LAVi) と心房回声検査で測定された心房張力 (LASct) は,源不明 (ESUS) の患者における心房動 (AF) を予測することができる. これらの指標は,AF検出のためのループレコーダーのモニタリングから利益を得る患者を選択するのに役立ちます.
科学分野:
- 心臓病科
- 神経学
- 医療用イメージング
背景:
- パロキシズム性心房細動 (AF) は,原因不明の栓塞性脳卒中 (ESUS) の潜在的な原因である.
- ループレコーダー (LR) はAFを検出しますが,ESUS患者での広範な使用は費用対効果が低い可能性があります.
- SPECKLE TRACKING ECHOCARDIOGRAPHY (STE) を用いた左心房機能の評価は,ESUSの患者がLRモニタリングから恩恵を受ける可能性があることを特定することができます.
研究 の 目的:
- STEによって評価されたLA機能が,AF検出のためのLRモニタリングから利益を得られるESUS患者を特定できるかどうかを評価する.
- ESUS患者におけるAF発生に対するLA機能パラメータの予測値を決定する.
主な方法:
- 2020年から2023年の間に連続してLRインプラントとエコーカルディオグラフィーを受けたESUS患者は登録されました.
- 患者は,LRによるAF検出に基づいて,平均10. 0ヶ月のフォローアップ期間中にグループ化されました.
- 左心室の体積指数 (LAVi) と,左心室の縦断 (LASr, LASct) は,STEを用いて測定された.
主要な成果:
- AF患者27人 (42. 2%) とAF患者37人 (57. 8%) が対象となった.
- AF群は,非AF群と比較して,著しく高いLAVi (44. 7対34. 4mL/ m2) と低いLASr (19. 7%対27. 4%) とLASct (7. 4%対12. 4%) を示した.
- 多変量分析により,LAViとLASctはAFの独立予測因子として特定されました.
結論:
- 左心房体積指数 (LAVi) とLA収縮ストレンス (LASct) は,ESUS患者におけるAFの信頼性の高い予測指標である.
- これらのエコーカルディオグラフィのパラメータは,AF検出のためのループレコーダーのインプラントから最も恩恵を受ける可能性が高いESUS患者の選択に役立ちます.
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