定量运动多普勒回声心脏学在无症状的膜大动脉狭窄症中的预后重要性
Patrizio Lancellotti1, Florence Lebois, Marc Simon
1Department of Cardiology, University Hospital of Liège, B-4000 Liege, Belgium. plancellotti@chu.ulg.ac.be
Circulation
|September 15, 2005
概括
定量多普勒运动心声学有助于识别患有无症状大动脉狭窄症的高风险患者. 这种方法提供了超越标准测试的有价值的预后信息,有助于对严重大动脉狭窄管理的临床决策.
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.
- 临床风险分层的临床风险分层
背景情况:
- 无症状的膜大动脉狭窄症需要风险分层.
- 使用运动测试,但数据有限.
- 定量运动多普勒回声心脏图的作用尚未研究.
研究的目的:
- 调查多普勒心力回声学定量运动在无症状严重大动脉狭窄风险分层中的作用.
- 为了确定运动多普勒回声心脏图是否提供了超越标准评估的预后价值.
主要方法:
- 69名患有严重无症状大动脉狭窄症的患者接受了休息和运动定量多普勒心声扫描.
- 患者在15个月内随访心脏事件.
- 多变量考克斯回归分析确定了心脏事件的独立预测因素.
主要成果:
- 26名患者有异常的运动反应,18名患者有心脏事件.
- 较高的峰值和平均跨膜压力梯度和较低的峰值射出分数与心脏事件有关.
- 异常的运动测试,增加的平均关压梯度 (>或=18 mm Hg) 和小的大动脉膜面积 (<0.75 cm2) 预测了心脏事件.
结论:
- 定量多普勒运动回声心电图对于识别患有无症状严重大动脉狭窄症的高风险患者非常有用.
- 这种技术比休息心电图和运动心电图提供了增量预后价值.
- 这些发现有助于临床决策,管理无症状严重的大动脉狭窄症.
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