对心室重塑的 mitrale 传单的适应:功能性 mitrale 吐患者的发生率和充分性
Miguel Chaput1, Mark D Handschumacher, Francois Tournoux
1Division of Cardiothoracic Surgery and Cardiac Ultrasound Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
Circulation
|August 6, 2008
概括
随着心室扭曲,心交叶片面积会增加,但相对于连接几何学来说,心交叶片尺寸不足会导致功能性心交叶片反 (MR). 这种适应变化可能解释了患者之间MR严重程度的差异.
科学领域:
- 心血管研究的心血管研究.
- 心脏机械学心脏机械学
- 心声回声扫描 (Echocardiography) 是一种心声回声扫描.
背景情况:
- 功能性腹反 (MR) 源于心室扭曲,导致腹在腹叶片上的抽缩引.
- 由于体内测量中的局限性,对 mitra 叶片区域对慢性绑定的适应能力仍然不太了解.
- 这项研究研究了功能性MR中 mitra 叶片区域的适应性变化及其对疾病严重性的影响.
研究的目的:
- 为了确定与健康个体相比,功能性MR患者的额头肌叶片面积是否增加.
- 为了测试假设,关叶片面积会影响功能性MR的严重程度.
- 探索小册子适应和左心室重塑之间的关系.
主要方法:
- 开发并验证了一种新的3D心声回声学方法,用于体内体外测量额头肌叶片面积.
- 将该方法应用于80名患者,分为三个组:正常对照组,功能性MR和没有MR的腹腔功能障碍.
- 分析了小册子面积,小册子到环形面积的比率,以及小册子到闭合面积的比率,与心脏几何形状和MR严重程度相关.
主要成果:
- 与正常受试者相比,左心室 (LV) 功能障碍的患者中,心室叶片面积显著增加 (35+/-20%).
- 虽然小册子与状区域的比率在各组中相似,但在功能性MR患者中,小册子总面积与关闭所需面积的比率减少了.
- 在调整为LV改造和绑定后,传单与封闭面积比率<1.7与显著的MR (OR 23.2,P=0.02) 有着强烈的关联.
结论:
- mitrale 传单区域适应慢性绑定在像扩张性心肌病和下壁运动异常等条件下.
- 当传单适应不足以满足连接的几何要求时,就会产生显著的功能性MR.
- 了解叶片适应机制和叶片区域的潜在治疗修改对于管理功能性MR异质性至关重要.
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