血液动力学验证三步HFA-PEFF算法,以诊断心力衰竭与保存的射出小部分的血液动力学验证
Ettore Lanzarone1, Claudia Baratto2, Marco Vicenzi3,4
1Department of Management, Information and Production Engineering, University of Bergamo, Dalmine, Italy.
ESC heart failure
|June 15, 2023
概括
心力衰竭协会 - 预测评估,心声图和尿分数,在不确定性情况下的功能测试,最终病因学 (HFA-PEFF) 算法显示了诊断心力衰竭与保留射出分数 (HFpEF) 的低灵敏度. 许多患者在非侵入性测试后被错误分类.
科学领域:
- 心脏病学 心脏病学
- 诊断算法 诊断算法
- 心脏衰竭研究研究
背景情况:
- 诊断心力衰竭与保存的喷射分数 (HFpEF) 可能是具有挑战性的.
- HFA-PEFF算法提供了一个逐步的方法来诊断HFpEF.
- 对侵入性血液动力学的验证对于诊断工具至关重要.
研究的目的:
- 为了验证三步HFA-PEFF算法与HFpEF的黄金标准血液动力学诊断.
- 为了评估HFA-PEFF算法的诊断性能,在运动性呼吸障碍患者.
- 为了评估透气应激心声学 (DSE) 和左心房应变在HFpEF诊断中的作用.
主要方法:
- 73名运动性呼吸障碍患者接受了HFA-PEFF算法,包括DSE.
- 休息和炼心脏右侧导管 (RHC) 作为血液动力学参考标准.
- 诊断性表现指标 (灵敏度,特异性) 为HFA-PEFF得分及其组件计算.
主要成果:
- 与RHC相比,HFA-PEFF算法在诊断HFpEF方面显示出较低的灵敏度 (45-46%).
- 在非侵入性测试后,很大一部分患者 (50%) 被错误地归类为非心脏性呼吸障碍.
- 在不确定的情况下,扩张应激心电回声对修改HFpEF概率的影响很小.
结论:
- 虽然HFA-PEFF算法具有结构,但其灵敏度不足以准确诊断HFpEF.
- 使用HFA-PEFF算法进行的非侵入性评估可能导致HFpEF的错误分类.
- 对HFpEF的非侵入性诊断策略的进一步改进是有必要的.
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