在严重的大动脉吐症中,在门更换后晚期持续的扩张性功能障碍
Bruno Villari1, Samuel Sossalla, Quirino Ciampi
1Division of Cardiology, Fatebenefratelli Hospital of Benevento, Benevento, Italy.
Circulation
|November 26, 2009
概括
大动脉置换在患有大动脉吐的患者中使左心室 (LV) 缩正常化,但持续的纤维缩和扩张功能障碍仍然存在,长期影响LV功能.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 心血管研究研究心血管研究
背景情况:
- 左心室 (LV) 缩和腹功能障碍在慢性大动脉反中很常见.
- 之前的研究表明,在大动脉狭窄时,大动脉置换 (AVR) 后,LV缩的回归.
- 在大动脉反中,AVR对LV功能和结构的影响需要进一步评估.
研究的目的:
- 评估AVR对慢性大动脉吐患者的LV功能和结构的早期和晚期影响.
主要方法:
- 在AVR前后 (21个月和89个月) 进行了LV双平面血管图,压力测量和内心肌组织活检的11名严重大动脉吐患者.
- 评估了 LV 缩功能 (排泄分数,中壁分数缩短) 和腹缩功能 (放松时间常数,峰值填充率,刚度常数).
- 通过肌肉纤维直径,间歇性纤维化和纤维含量来评估LV结构.
主要成果:
- 在AVR后晚期,LV肌肉质量显著减少了55%.
- 在AVR后晚些时候,LV放松正常化,而射出分数保持不变.
- 腹筋硬度在AVR后仍然升高,间歇性纤维化在手术后晚期减少.
结论:
- 在大动脉吐患者中,AVR导致宏观LV缩的正常化.
- 然而,在AVR后晚期观察到持续的纤维增大和扩张功能障碍.
- 这些结构变化与被动弹性特性变化和持续的扩张功能障碍相关.
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