在没有心脏症状的类风湿性关节炎患者中,可以检测到心肌功能障碍吗?
G Akgöl1, A Gülkesen, E Y Uslu
1Department of Physical Medicine and Rehabilitation, Firat University, Elazig, Turkey. drgurkanakgol@firat.edu.tr.
概括
类风湿性关节炎 (RA) 患者与健康人群相比,通过组织多普勒和心肌性能指数 (MPI) 检测到心脏功能受损. 这些方法有助于在RA中早期发现心室功能障碍.
科学领域:
- 心脏病学 心脏病学
- 类风湿病学 类风湿病学
- 医疗成像医学成像
背景情况:
- 类风湿性关节炎 (RA) 是一种系统性自身免疫性疾病,可以影响心血管系统.
- 早期发现心脏参与RA对于预后和治疗优化至关重要.
- 组织多普勒和心肌性能指数 (MPI) 是用于评估心脏功能的回声心脏学参数.
研究的目的:
- 研究组织多普勒和MPI在评估无症状RA患者心脏参与中的作用.
- 为了比较RA患者和健康对照者之间的心脏测量.
- 确定这些参数是否可以预测心血管疾病风险和RA的预后.
主要方法:
- 包括50名RA患者和50名健康对照.
- 进行了标准心声回声,常规多普勒和组织多普勒心声回声.
- 计算了心肌性能指数 (MPI);RA患者被分为血清阳性和血清阴性亚组.
主要成果:
- 与对照组相比,RA患者的左心脏直径,E/A,E/e和MPI值呈现出统计学上显著的差异.
- 左心脏直径在血清阴性RA患者显著高于血清阳性RA患者.
- 两组之间的PR间隔没有显著差异,DAS28分数和心脏参数之间也没有相关性.
结论:
- 与健康对照组相比,RA患者表现出受损的组织多普勒测量和MPI结果.
- MPI和组织多普勒回声心电图是早期检测RA中心室功能障碍的宝贵工具.
- 这些发现可以在临床实践中帮助预测RA患者的预后和优化治疗.
相关概念视频
01:22Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
38
The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
38
01:20Rheumatic Heart Disease IV: Nursing Management
24
AssessmentA comprehensive assessment is essential in managing a patient with rheumatic heart disease (RHD). Begin with obtaining a detailed medical history, including recent streptococcal infections, a history of rheumatic fever, or previously diagnosed rheumatic heart disease. Assess the patient for symptoms such as fever, chest pain, widespread joint pain (arthralgia), tachycardia, pericardial friction rub, muffled heart sounds, heart murmurs, peripheral edema, subcutaneous nodules, and...
24
01:23Rheumatic Heart Disease I: Introduction
21
Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...
21
01:27Myocarditis II: Clinical Features and Diagnostic Tests
12
Myocarditis is an inflammation of the heart muscle. The symptoms vary widely, encompassing asymptomatic presentations to severe, acute manifestations.Clinical PresentationAsymptomatic cases: In some instances, myocarditis may be asymptomatic, with the infection resolving without intervention. These cases often go undetected unless discovered incidentally through diagnostic imaging or tests conducted for other reasons.General Early Symptoms: Early symptoms of myocarditis are non-specific and can...
12
01:21Rheumatic Heart Disease III: Medical Management
22
Rheumatic heart disease (RHD) management can be divided into two main strategies: prevention and long-term management.Primary PreventionPrimary prevention focuses on timely diagnosis and management of group A streptococcal pharyngitis to prevent acute rheumatic fever. The most widely used antibiotic for treating this condition is intramuscular benzathine penicillin G.Acute Rheumatic Fever TreatmentThe primary treatment goal for a patient diagnosed with acute rheumatic fever is to suppress the...
22
01:29Cardiomyopathy IV: Restrictive Cardiomyopathy
12
Restrictive cardiomyopathy (RCM) is a rare heart muscle disease characterized by impaired ventricular filling due to stiffened ventricular walls, leading to significant diastolic dysfunction.EtiologyRestrictive cardiomyopathy can arise from both inherited and acquired diseases, many of which are systemic. It is categorized into four main types: infiltrative, storage, non-infiltrative, and endomyocardial diseases.Infiltrative diseases, such as amyloidosis, lead to RCM by depositing amyloid...
12