在密码性中风中检测心房动的心脏回声仪:一个元分析
Mohab Hassib1, Kirolos Barssoum1, Ashish Kumar2
1Department of Cardiovascular Medicine, University of Texas Medical Branch, Galveston, TX.
Current problems in cardiology
|June 21, 2023
概括
通过心声学测量的左心房储压力 (LARS) 可以识别患有高风险发展心房动 (AF) 的密码性中风 (CS) 患者. 较低的LARS表明在CS之后未来AF的风险更高.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 医疗成像医学成像
背景情况:
- 密码性中风 (CS) 占缺血性中风的很大一部分.
- 前庭动 (AF) 是CS的主要原因,需要早期检测和风险分层.
- 识别高风险的AF后CS患者对于及时干预和中风预防至关重要.
研究的目的:
- 评估左心房 (LA) 斑点跟踪回声心脏学在识别具有高风险发展AF的CS患者时的有效性.
- 确定LA菌株参数是否可以指导选择从长期节律监测设备中受益的患者.
主要方法:
- 进行了观察性研究的系统审查和元分析.
- 在Cochrane图书馆,MEDLINE和EMBASE进行了搜索,以寻找新发性肌痛和以前没有AF的患者的研究.
- 分析了左心房应变参数,特别是LA储应变 (LARS),并使用随机效应模型进行了聚合.
主要成果:
- 包括13项研究,涉及3031名新的CS患者.
- 随访时发生AF的患者 (n=420) 与没有发展AF的患者相比,LARS显著减少 (n=2611) [MD: -8.61;95%CI: -10.76, -6.47].
- 观察到很高的异质性 (I2 = 85%),表明研究之间的变化.
结论:
- 呈现时左心室储压力降低 (LARS) 是密码性中风患者未来AF发展的重要预测因素.
- 拉斯维加斯的斑点追踪回声心脏图像显示,它是一个有前途的工具,用于CS患者的风险分层.
- 需要进一步的研究来验证这些发现,并确定LARS作为CS中AF风险的临床标志物.
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