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右心室功能的负荷依赖是在心室辅助器件植入之前在决策中需要考虑的一个主要因素
Michael Dandel1, Evgenij Potapov, Thomas Krabatsch
1Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Berlin, Berlin, Germany (M.D., E.P., T.K., A.S., A.L., J.V., C.K., R.H.); and German Centre for Cardiovascular Research (DZHK), partner site Berlin, Germany (R.H.).
Circulation
|September 14, 2013
概括
在左心室辅助装置 (LVAD) 植入后预测右心室 (RV) 功能至关重要. 手术前的RV几何和收缩速度,加上压力负荷和三回,可以改善RV功能预测.
科学领域:
- 心脏病学 心脏病学
- 心血管外科心血管外科
- 医疗器械 医疗器械
背景情况:
- 左心室辅助装置 (LVAD) 提供比双心室装置更好的结果.
- 在LVAD植入后预测右心室 (RV) 功能仍然是一个挑战.
- 在手术前评估RV负载依赖性是改善决策的关键.
研究的目的:
- 在LVAD植入之前和之后评估VR负载依赖性.
- 为了改善LVAD植入后VR功能的术前预测.
主要方法:
- 分析了205名接受LVAD植入的患者的数据.
- 使用了实验室,心声回声和右心导管数据.
- 相关的手术前RV参数与术后RV功能.
主要成果:
- 在手术前的RV几何 (短/长轴比) 和收缩速度 (三环速度,张力率) 在RV衰竭和没有RV衰竭的患者之间有显著差异.
- 这些参数的特定值,结合RV压力负荷 (ΔPRV-RA) 和三腹吐,预测了术后RV衰竭.
- 车载载荷适应指数显示了特殊的预测价值.
结论:
- 手术前的RV几何和收缩速度是术后RV功能的重要预测因素.
- 结合RV压力负荷和三腹反,可以提高预测准确度.
- 这些发现可以改善LVAD候选人的手术前决策.
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