对右心室外流管功能障碍进行肺置换后的双心室反应:年龄是预测结果的因素吗?
Alessandra Frigiola1, Victor Tsang, Catherine Bull
1Cardiothoracic Unit, Great Ormond Street Hospital for Children, Great Ormond Street, London WC1N 3JH, UK. alessandra.frigiola@gmail.com
Circulation
|October 10, 2008
概括
肺置换 (PVR) 改善了先天性心脏病患者的心脏功能和运动能力. 在17.5岁之前进行PVR优化了结果,特别是在右心室体积和运动反应方面.
科学领域:
- 心脏病学 心脏病学
- 儿童心脏病学 儿童心脏病学
- 心脏外科手术 心脏外科手术
背景情况:
- 在先天性心脏病中肺不适症的肺置换 (PVR) 的时间是具有挑战性的.
- 肺部反显著影响心脏功能和患者的结果.
研究的目的:
- 评估PVR肺部反后改善的决定因素.
- 确定用于比较不同患者年龄组的临床结果的预测因素.
主要方法:
- 71名患有严重肺吐的患者接受了PVR.
- 使用MRI和心肺运动测试在PVR前后进行评估的变化.
- 分析了右心室和左心室的体积,心脏输出和呼吸反应.
主要成果:
- PVR改善了纽约心脏协会的排名,并显著减少了右心室体积.
- 在PVR后,左心室终端透缩体积增加,有效心脏输出量增加.
- 对二氧化碳的呼吸系统反应正常化发生在年龄小于17.5岁的患者中更频繁.
结论:
- 积极的PVR策略使RV体积正常化,改善双心脏功能,提高运动能力.
- 17.5岁之前的手术与正常化呼吸反应和更好的LV功能有关.
- 早期PVR与手术后改善左心室填充和缩功能有关.
相关概念视频
Heart Failure IV: Classification and Diagnostic Evaluation
252
Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...
252
Mitral Stenosis I: Introduction
343
Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
343
Mitral Regurgitation III: Medical Management
220
Mitral regurgitation (MR) is characterized by retrograde blood circulation from the left ventricle into the left atrium due to inadequate mitral valve closure. The severity of the condition, symptoms, and underlying cause determine treatment strategies.Monitoring and Pharmacological TreatmentPatients with mild to moderate MR typically do not need immediate intervention but regular monitoring to assess progression and guide treatment. Patients with mild MR should have an echocardiogram every 3-5...
220
Mitral Regurgitation II: Clinical Features and Diagnostic Tests
263
Mitral regurgitation (MR) is a valvular heart disorder in which the mitral valve fails to close tightly, allowing blood to leak backward into the heart. Understanding the clinical manifestations, assessment, diagnostic findings, and medical management of MR is crucial to effectively managing affected patients.Clinical Manifestations of Mitral RegurgitationMitral regurgitation can be acute or chronic, each presenting differently and requiring different approaches:1. Acute Mitral...
263
Mitral Regurgitation I: Introduction
316
Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
316
Mitral Valve Prolapse II: Assessment and Management
316
IntroductionA range of clinical features characterizes Mitral Valve Prolapse (MVP), but it is important to note that many individuals with MVP are asymptomatic and may remain so throughout their lives. For those who do exhibit symptoms, the following are the key clinical features:Palpitations: This is a common symptom where individuals feel an irregular or rapid heartbeat. Palpitations in MVP are often due to arrhythmias such as premature ventricular contractions or supraventricular...
316


