患有单个或全身右心室患者的心力衰竭和心室功能障碍
Sanaz Piran1, Gruschen Veldtman, Samuel Siu
1Congenital Cardiac Centre for Adults, Toronto General Hospital, University Health Network, University of Toronto, University of Toronto, Canada.
Circulation
|March 13, 2002
概括
有单一或全身右心室的成年人面临心力衰竭和死亡的高风险. 早期识别和干预对于保持心室功能和改善结果至关重要.
科学领域:
- 心脏病学 心脏病学
- 遗传性心脏病是一种先天性心脏病.
- 成年人的先天性心脏病
背景情况:
- 以前的研究表明,单一/全身右心室患者的充血性心力衰竭率很高.
- 成年人群中的风险在很大程度上是未知的.
研究的目的:
- 评估成人患者心力衰竭的风险,其中包括单个或全身右心室.
- 在这个人群中确定心力衰竭和死亡率的预测因素.
主要方法:
- 对188名患有单一或全身右心室的成年患者的前性评估.
- 利用封闭的放射性核素血管学和2D心声学进行心室评估.
- 临床后续包括纽约心脏协会 (NYHA) 的分类和死亡率跟踪.
主要成果:
- 根据手术史,心力衰竭的发病率有所不同:22.2% (用末手术转移大动脉),32.3% (先天纠正转移),40% (Fontan-palliated).
- 有症状的患者表现出明显较低的无氧值和峰值氧气消耗 (VO2).
- 系统性心室喷射分数在有症状与无症状患者 (34.8%与46.7%) 中显著降低.
- 与无症状患者 (5%) 相比,有症状患者 (47.1%) 的死亡率在15.7年内明显高.
- NYHA类,全身喷射率和手术时的年龄是死亡率的关键预测因素.
结论:
- 患有单一或全身右心室的患者面临心力衰竭和相关高死亡率的显著风险.
- 识别有风险的个体对于实施保护心室功能的策略至关重要.
- 积极主动管理对于改善这种脆弱患者群体的长期结果至关重要.
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