在心脏性休克中,对早期重血管化的生存和反应的心声心脏学预测因素
Michael H Picard1, Ravin Davidoff, Lynn A Sleeper
1Massachusetts General Hospital and Harvard Medical School, Boston, Mass 02114, USA. MHPicard@partners.org
Circulation
|January 23, 2003
概括
心声图显示,左心室喷射分数 (LVEF) 和 mitrale regurgitation (MR) 的严重程度预测心脏性休克的存活率. 早期再血管化 (ERV) 有利于患者,无论他们最初的LVEF或MR.
科学领域:
- 心脏病学 心脏病学
- 医疗成像医学成像
- 关键护理医学 关键护理医学
背景情况:
- 声心图对于诊断和管理心肌梗塞至关重要.
- 在心脏性休克中早期心脏结构/功能特征的预后价值仍然不清楚.
- 我们是否应急地为心脏病性冲击 (SHOCK) 试验进行封闭冠状动脉再血管化,研究了早期再血管化 (ERV) 与初始医疗稳定 (IMS).
研究的目的:
- 描述心脏病性休克时的心声图形特征.
- 确定预测结果的早期心声回声学发现.
- 检查特征-治疗相互作用以及对ERV生存益处的见解.
主要方法:
- 在随机化后24小时内对175个心声回声图进行定量评估.
- 从SHOCK试验中分析了169个合适的心声回声图.
- 多变量分析以确定生存的独立预测因素.
主要成果:
- 平均左心室喷射分数 (LVEF) 为31%;39.1%的患者有中度或较大的腹 (MR).
- 生存的独立预测因素是MR严重程度和LVEF.
- 在所有LVEF和MR水平上,ERV策略显示了生存益处.
结论:
- 急性心脏性休克呈现出各种心脏异常.
- 最初的LVEF和MR严重程度预测短期和长期死亡率.
- 无论基线LVEF或MR严重程度如何,ERV都会提供好处.
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