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消除式肺栓塞的神话 (从式肺栓塞与非式肺栓塞的比较中)
Ameesh Isath1, Ravi Shah1, Dhrubajyoti Bandyopadhyay1
1Department of Cardiology, Westchester Medical Center, New York Medical College Valhalla, New York.
The American journal of cardiology
|July 5, 2023
概括
坐肺栓塞 (SPE) 不会导致显著的近道流动阻塞. 非SPE与急性肺栓塞患者的右室功能障碍有关,挑战了关于稳定性的假设.
科学领域:
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
- 放射学 放射学是一门学科.
背景情况:
- 急性肺栓塞 (PE) 经常带有式PE (SPE) 和临床严重性增加之间的假定联系.
- SPE对近壁肺动脉 (PA) 流通阻塞和右心室 (RV) 功能的实际影响需要进一步调查.
研究的目的:
- 为了确定由SPE引起的近端PA流障碍的程度.
- 评估SPE对急性PE患者需要干预的VR功能的影响.
- 为了比较SPE和非SPE队列之间的临床严重程度和结果.
主要方法:
- 一个单中心系列174急性PE患者与VR功能障碍 (2005-2022) 通过CT扫描被分类为SPE或非SPE.
- 流量阻塞量化为右和左PA中的凝块与PA表面积比.
- 使用临床参数,CT和跨胸心回声学评估RV功能.
主要成果:
- 在SPE患者中,平均有25.9%的全流阻塞.
- 非SPE患者显示出更大的临床VR功能障碍,包括更高的高风险PE率 (43.9%对26.1%),需要VA-ECMO (21.9%对10.9%) 和心肺复苏 (16.7%对7.8%).
- RV:LV比率和VR分数面积变化相似;在医院的死亡率也在各组之间相似.
结论:
- 在急性PE与VR功能障碍中,SPE似乎不会导致近端流量限制阻塞.
- 非SPE与比SPE更严重的临床VR功能障碍有关.
- 非SPE的存在不应被解释为患者稳定性的明确标记.
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