在特殊人群中对透析功能的心声评估
Nicholas Chan1, Tom Kai Ming Wang2, Chris Anthony2
1Seymour, Paul, and Gloria Milstein Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center and New York Presbyterian Hospital, New York, New York.
The American journal of cardiology
|July 10, 2023
概括
在特殊的患者群体中,评估左心室 (LV) 扩张功能障碍需要谨慎. 本综述提供了解决方案,用于评估LV填充压力 (LVFPs) 使用额外的多普勒指数超出标准指南.
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.
- 心血管生理学心血管生理学
背景情况:
- 左心室 (LV) 扩张功能障碍涉及放松功能受损,恢复力减少和腔室刚度增加.
- 非侵入性评估通常使用额头流量,环形速度,三回速度和左心房体积指数作为填充压力的替代标记.
- 对于透析功能和LV填充压力 (LVFP) 估计的传统算法可能会在患有心肌病,膜疾病,心律失常或心脏手术后的患者中失败.
研究的目的:
- 为在标准指南不足的特殊患者群体中提供评估LVFP的解决方案.
- 为了说明在独特的临床场景中对扩张功能评估的挑战.
- 促进一种更全面的方法来评估透气功能.
主要方法:
- 审查现有的文献和指导方针对心声回声评估的透气功能.
- 在特定患者群体中分析当前多参数方法的局限性.
- 纳入额外的多普勒指数,以进行增强的LVFP估计.
主要成果:
- 标准回声心脏学参数用于腹功能和LVFP估计在特定患者队列中不可靠.
- 补充多普勒指数,包括异体体松时间, mitra减速时间和肺静脉流,可以帮助准确评估.
- 在复杂的情况下,需要采用量身定制的多参数方法来精确评估LVFP.
结论:
- 目前用于评估透气功能的指导方针需要适应患有特定心脏病的患者.
- 使用更广泛的多普勒回声心脏学参数对于在具有挑战性的群体中准确评估LVFP至关重要.
- 综合性评估可以增强腹功能障碍患者的临床决策.
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