在接受血栓溶解的患者中,左心室喷射小部分与急性缺血性中风结果的关联
Ryan C H Chee1, Norman H Lin2, Jamie S Y Ho2
1Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore.
Journal of cardiovascular development and disease
|June 27, 2023
概括
在急性缺血性中风 (AIS) 患者的左心室缩功能障碍 (LVSD) 经受血栓溶解的患者与更糟糕的结果有关. 这种情况增加了死亡率,心力衰竭入院率和心肌梗塞风险,需要优化LVEF.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 脑卒中医学 脑卒中医学
背景情况:
- 左心室缩功能障碍 (LVSD) 对接受血栓溶解的急性缺血性中风 (AIS) 患者的结果的影响尚不清楚.
- LVSD的特点是左心室喷射率 (LVEF) 低于50%.
研究的目的:
- 为了研究LVSD与AIS患者的功能和临床结果之间的关联,用血栓溶解治疗.
- 为了确定LVSD是否预测死亡率,心力衰竭 (HF) 住院,心肌梗塞 (MI) 或复发性中风/暂时性缺血性发作 (TIA).
主要方法:
- 对937名AIS患者进行血栓溶解的回顾性观察研究 (2006-2018).
- 定义为LVEF<50%的LVSD.
- 统计分析包括人口统计学逻辑回归,功能结果的顺序转移回归 (修改的兰金尺度 - mRS),以及生存分析的Cox比例危险模型.
主要成果:
- 患有LVSD的患者 (n=190) 与LVEF≥50% (n=747) 患者相比有更多的并发症,包括糖尿病,心房动,缺血性心脏病和高血压.
- 在3个月后,LVSD与功能性mRS结果的恶化有关 (调整后的OR 1.41).
- LVSD显著预测了所有原因的死亡率 (aHR 3.38),HF入院 (aHR 4.23),和MI (aHR 2.49),但不是复发性中风/TIA (aHR 1.15).
结论:
- 在接受血栓溶解的AIS患者中,LVSD与增加全因死亡率,HF入院和MI有关.
- 在患有LVSD的AIS患者中观察到较差的功能结局.
- 优化LVEF对于改善这一患者群体的治疗结果至关重要.
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