大动脉狭窄的左心室缩功能障碍:病理生理学,诊断,管理和未来的方向
Nikolaos Spilias1, Trejeeve Martyn1, Kara J Denby1
1Department of Cardiovascular Medicine, Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Structural heart : the journal of the Heart Team
|June 8, 2023
概括
退行性性大动脉狭窄 (AS) 可以导致左心室 (LV) 系统功能障碍,导致不良结果. 先进的成像技术有助于早期检测,并指导及时更换大动脉 (AVR),以改善患者的预后.
科学领域:
- 心脏病学 心脏病学
- 膜心脏疾病 膜心脏疾病
- 心脏成像 - - 心脏成像
背景情况:
- 退行性性大动脉狭窄症 (AS) 是最常见的膜心脏病.
- 它经常与左心室 (LV) 缩功能障碍共存,影响患者的结果.
- 肌细胞亡和心肌纤维化驱动从LV缩到心力衰竭的进展.
研究的目的:
- 审查AS中LV缩功能障碍的病理生理学和结果.
- 要突出先进的成像技术,用于早期检测LV功能障碍和重塑.
- 讨论主动脉置换 (AVR) 的最佳时间和未来的治疗策略.
主要方法:
- 关于AS,LV功能障碍和心脏成像的当前文献的审查.
- 讨论用于LV评估的回声心脏图像和心脏磁共振成像.
- 对AS的预后影响和治疗策略的分析.
主要成果:
- 在AS中,受损的LV缩功能与更糟糕的结果有关,即使在AVR后.
- 先进的成像可以早期识别可逆的LV功能障碍和重塑.
- 过导管AVR提供了优秀的结果,促使人们考虑更早的干预.
结论:
- 早期检测和干预对于管理LV静脉缩功能障碍的AS至关重要.
- 先进的成像在指导AVR定时方面发挥着关键作用.
- 未来的AS治疗可能会超出当前指南的适用范围.
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