左心室纵向功能预测危及生命的心室节律失常和死亡在成年人修复的四重法洛特
Gerhard-Paul Diller1, Aleksander Kempny, Emmanouil Liodakis
1Adult Congenital and Valvular Heart Disease Center, Department of Cardiology and Angiology, University Hospital of Münster, Albert-Schweitzer-Strasse 33, 48149 Muenster, Germany. gerhard.diller@gmail.com
Circulation
|April 13, 2012
概括
在Fallot患者的修复四重症中,突然心脏死亡的风险与左心室纵向功能障碍有关. 声心图右心脏测量与LV菌株相结合,改善了预后预测.
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.
- 遗传性心脏病是一种先天性心脏病.
背景情况:
- 患有Fallot四重症修复的成年人面临突然心脏死亡和心室节律失常的风险.
- 纵向左心室 (LV) 功能评估可以早期检测心肌损伤并帮助预后.
研究的目的:
- 评估LV纵向功能的预后价值和回声心脏图右心脏参数,用于预测Fallot患者修复四重症的不良结果.
- 为了确定LV菌株和其他心声回声测量是否可以改善风险分层,超出QRS持续时间等既定标志物.
主要方法:
- 追溯分析了413名Fallot患者的成人四分法.
- 评估LV的全球纵向二维应变和中枢环状平面缩外流.
- 评估右心脏参数,包括右心房区域和右心室部分区域的变化.
- 综合终点包括心脏突然死亡,持续的腹腔动脉高心率和适当的植入式心脏转换器-除器放电.
主要成果:
- 全球LV纵向应变和状环状平面缩外流独立地与不良结果相关.
- 一组心声回声学变量 (右心房区域,RV小区变化,LV菌株/MAPSE) 的组合显著预测了结果 (c统计,0.70).
- 在单变量分析中,QRS 持续时间,右心房区域,RV 分数面积变化,RV 出流管径,MAPSE 和 LV 纵向菌株都显著.
结论:
- 在这个人群中,左心室纵向功能障碍是突然心脏死亡和危及生命的心室节律失常的重要预测因素.
- 常规回声心脏学评估LV纵向功能和右心参数提供了有价值的预后信息.
- 这些心声回声测量作为一个有用的辅助QRS持续时间的风险估计在患者修复的Fallote四重律.
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