右心室から肺動脈への非侵襲的右心室離合の予測価値は,左心室アシスト装置の植入後,右心室不全に対する右心室離合の予測値です
Kayo Misumi1, Toru Hashimoto1, Takeo Fujino1,2
1Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University.
まとめ
耐久性のある左心室補助装置の埋め込み後の早期の右心室不全を予測することができます. 肺動脈シストリック圧力比に対する三角形環状平面シストリックエクスクルッションは,リスク層分化の貴重な予測指標です.
科学分野:
- 心臓病学 心臓病学
- 心血管外科手術についてです.
- 医療機器 医療機器について
背景:
- 耐久性左心室補助器具 (dLVAD) の移植後の早期右心室不全 (eRVF) は,不良の結果と関連しています.
- eRVFの予測パラメータは,まだ完全に確立されていない.
研究 の 目的:
- 右心室 (RV) から肺動脈 (PA) の分離によるERVFの予測値を評価する.
- 三環状平面シストリックエクスクルション (TAPSE) とPAシストリック圧力 (PASP) の比率を予測として評価する.
主な方法:
- dLVADインプラントを施した111人の成人の患者の遡及的分析.
- 術前エコーカルディオグラフィーと右側心臓キャセテリゼーションのデータを分析した.
- eRVFは,植入後30日以内に循環器のサポートまたはイノトロプ的サポートの必要性として定義されます.
主要な成果:
- 患者の46.8%が術後のeRVFを発症した.
- TAPSE/PASP比は eRVFを独立して予測した.
- TAPSE/PASPの調整されたオッズ比率は,エコーカルディオグラフィとキャセテリゼーションの変数ではそれぞれ0.05 (P=0.024) と0.04 (P=0.027) でした.
結論:
- TAPSE/PASP比で測定される手術前のRV-PA解離は,dLVAD後のeVRFを予測することができます.
- このアクセシブルなパラメータは,手術前のリスクの階層化と手術後の管理に役立ちます.
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