左心房功能指数预测,通过皮肤冠状动脉干预治疗的STEMI患者的治疗结果不佳
Yi Tang1, Pei Huang2, Zhibin Liu1
1Department of Cardiology, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Clinical Medicine Research Center of Heart Failure of Hunan Province, Hunan Normal University, Changsha, 410005, China.
Scientific reports
|June 21, 2023
概括
左心房功能指数 (LAFI) 强烈预测穿皮冠状动脉干预 (PCI) 后ST升高心肌梗塞 (STEMI) 患者的不良事件. 这种心声回声测量提供了有价值的预后信息,可以改善患者的治疗结果.
科学领域:
- 心脏病学 心脏病学
- 心声回声扫描 (Echocardiography) 是一种心声回声扫描.
- 临床预后 临床预后
背景情况:
- 急性ST升高心肌梗塞 (STEMI) 具有显著的心血管风险.
- 穿皮冠状动脉干预 (PCI) 是STEMI的主要治疗方法.
- 在PCI后的STEMI患者中,左心房功能指数 (LAFI) 的预后作用仍然不清楚.
研究的目的:
- 在接受PCI的STEMI患者中研究LAFI对心血管不良事件的预测价值.
- 为了确定LAFI是否在这个人群中起到独立的预后标记的作用.
主要方法:
- 有望招募156名接受PCI治疗的STEMI患者.
- 在基线和随访时进行的跨胸腔心声学.
- 综合终点事件的评估,包括在中位数14个月的随访期间重新住院和心血管死亡.
主要成果:
- 对于终点事件,LAFI显示了最高的预测准确性 (AUC 0.90).
- 在多变量分析中,LAFI被确定为一个独立的预测因子 (HR:0.91,P < 0.0001).
- 患有LAFI≤42.25cm/cc/m2的患者出现的不良事件显著增加 (HR:19.15,P<0.001).
结论:
- 该LAFI是PCI治疗的STEMI患者预后的强大和独立预测器.
- 对左心房功能的心声扫描评估可以帮助风险分层.
- 在PCI后,LAFI可以指导STEMI患者的临床管理和监测.
相关概念视频
01:30Acute Coronary Syndrome I: Introduction
33
Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
33
01:30Acute Coronary Syndrome III: Diagnostic Studies
11
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
11
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
22
The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
22
01:29Cardiomyopathy III: Hypertrophic Cardiomyopathy
17
Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
17