缺血性额头吐:长期结果和预后影响与定量多普勒评估
F Grigioni1, M Enriquez-Sarano, K J Zehr
1Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA.
Circulation
|April 3, 2001
概括
在慢性心肌梗塞 (MI) 后的阶段,缺血性腹反 (IMR) 的存在显著增加了死亡风险. 通过吐体积和有效的吐孔来衡量IMR的程度,与这种风险增加直接相关.
科学领域:
- 心脏病学 心脏病学
- 心声回声扫描 (Echocardiography) 是一种心声回声扫描.
- 心脏外科手术 心脏外科手术
背景情况:
- 心肌梗塞 (MI) 可能会导致缺血性额回 (IMR).
- IMR是已知的急性和早期MI后阶段的不良预后指标.
- 在慢性后心脏病发作阶段IMR的预后影响还不清楚.
研究的目的:
- 调查IMR在慢性后MI患者的预后影响.
- 确定IMR的存在和严重程度是否与死亡率增加有关.
- 评估IMR量化对风险分层的价值.
主要方法:
- 对303名先前患有Q波MI (>16天) 的患者的分析.
- 胸外心声扫描以评估IMR,吐量 (RVol) 和有效吐孔 (ERO) 面积.
- 总和心脏病死亡率的5年随访,使用多变量分析.
主要成果:
- 与没有IMR的患者相比,IMR患者的5年总死亡率 (62%vs39%) 和心脏死亡率 (50%vs30%) 显着更高.
- IMR的存在是增加总和心脏病死亡率的独立预测因素 (aRR分别为1.88和1.83).
- 较高程度的IMR (RVol≥30mL或ERO≥20mm2) 与进一步增加的死亡风险有关.
结论:
- 在慢性后心脏病发作阶段,IMR存在与过度死亡率有关,独立于基线特征和心室功能障碍.
- 死亡风险随着IMR的程度升级而升级,根据ERO和RVol.量化,IMR的程度升级.
- 检测和量化IMR对于慢性后MI患者的风险分层和临床决策至关重要.
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