胎儿的隔离性心房阻塞:对175名患者进行了一项回顾性,多国,多中心的研究
Håkan Eliasson1, Sven-Erik Sonesson, Gurleen Sharland
1Pediatric Cardiology Q1:03, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden. hakan.eliasson@karolinska.se
Circulation
|October 12, 2011
概括
胎儿心房阻塞 (AV阻塞) 具有显著的死亡风险. 在这项研究中,类固醇治疗没有提高生存率,这突显了早期识别风险因素对于更好的胎儿结果的重要性.
科学领域:
- 心脏病学 心脏病学
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 儿童心脏病学 儿童心脏病学
背景情况:
- 在胎儿中,孤立的完整心房阻塞 (AV阻塞) 是罕见的,可能致命的.
- 类固醇治疗对胎儿AV阻塞结果的影响尚不清楚.
- 孕产妇的抗Ro/SSA抗体经常与胎儿的AV阻塞有关.
研究的目的:
- 为了确定胎儿心房阻塞死亡的风险因素.
- 评估化皮质类固醇治疗对胎儿AV阻塞结果的影响.
主要方法:
- 在2000年至2007年期间,对175名被诊断为二级或三级AV阻塞的胎儿进行了回顾性分析.
- 对抗体状况的评估,用化皮质类固醇治疗以及临床结果.
- 统计分析以确定与死亡率相关的变量.
主要成果:
- 91%的胎儿在出生时幸存下来,93%的胎儿在新生儿时期幸存下来,在类固醇治疗和未治疗组的生存率相似.
- 死亡的关键风险因素包括妊娠年龄<20周,心室速率≤50bpm,胎儿水滴和左心室功能受损.
- 这些风险因素独立地增加了出生前死亡风险的10倍和新生儿期的6倍.
结论:
- 妊娠年龄<20周,低心室速率,胎儿水滴和左心室功能受损是胎儿AV阻塞不良结果的关键风险因素.
- 用化皮质类固醇治疗对生存率没有显著影响.
- 长期跟踪显示,三分之二的幸存者在一岁时需要起器,有些人患有心肌病.
相关概念视频
01:18Dysrhythmias IV: Characteristics of Bradyarrhythmias
Bradyarrhythmias are cardiac rhythm disorders characterized by a slower-than-normal heart rate, typically defined as fewer than 60 beats per minute. Some of which are discussed here:Sinus BradycardiaSinus bradycardia presents a heart rate lower than 60 beats per minute, with a regular rhythm originating from the SA node. The ECG typically shows normal P waves preceding each QRS complex, a normal PR interval (0.12 to 0.20 seconds), and a normal QRS duration (0.06 to 0.10 seconds).First-Degree AV...
01:23Mitral Stenosis II: Clinical features and Diagnostic Tests
Mitral stenosis is a heart condition in which the mitral valve, which allows blood to flow from the left atrium to the left ventricle, becomes narrowed or stenotic. This narrowing hinders blood flow and leads to clinical symptoms requiring specific medical evaluations and management strategies. The following overview outlines the clinical symptoms, assessments, diagnostic findings, prevention methods, and treatments for mitral stenosis.Clinical ManifestationsDyspnea (shortness of breath): This...