心脏"缩"表型:在心声回声图上区分病因与左心室壁厚度增加的病因
Aaisha Ferkh1,2, Catherina Tjahjadi3, Luke Stefani1,2
1Westmead Clinical School, University of Sydney, Westmead, NSW, Australia.
Frontiers in cardiovascular medicine
|July 19, 2023
概括
心声学可以区分心脏粉症 (CA) 和安德森-法布里病 (AFD) 和高血压心脏病 (HHT). 像EFSR和MSR这样的特定心声回声标记有效地区分这些疾病,帮助诊断.
科学领域:
- 心脏病学 心脏病学
- 医疗成像医学成像
- 生物医学工程 生物医学工程
背景情况:
- 区分心脏"缩"表型对于患者的管理和预后至关重要.
- 胸外心声学是评估左心室 (LV) 壁厚度增加的主要查工具.
- 从临床上来说,区分透性/储存性疾病,如心肌粉症 (CA) 和安德森-法布里病 (AFD) 与高血压性心脏病 (HHT) 是非常重要的.
研究的目的:
- 识别可区分CA和AFD与HHT的回声心脏学标记.
- 为了评估特定参数的实用性,例如相对顶峰节约比率 (RAS),LV喷射分数与应变比率 (EFSR),质量与应变比率 (MSR) 和粉样粉症指数 (AMYLI) 评分.
主要方法:
- 对209名患者 (120名CA,31名AFD,58名HHT) 的回顾性分析.
- 评估LV结构性,缩性和腹功能,包括全球 (LVGLS) 和细分纵向菌株.
- 评估之前报告的心声回声学参数 (RAS,EFSR,MSR,AMYLI).
主要成果:
- 与HHT相比,在CA和AFD中,LV质量指数明显高于CA和AFD.
- LVGLS在CA中最低,其次是AFD,然后是HHT.
- 在EFSR和MSR中,从HHT中区分了二次性多变性表型 (CA + AFD) (ROC-AUC为0.80和0.91).
- 拉斯和艾米利分数将CA与AFD区分开来 (ROC-AUC为0.79和0.80).
- 一种线性差异分析模型正确地分类了79%的病例.
结论:
- 简单的心声回声学参数可以有效地区分各种"过度缩"的心脏表型.
- 这些心声回声标记显示出作为查工具的潜力,以指导进一步的诊断测试.
相关概念视频
Cardiomyopathy III: Hypertrophic Cardiomyopathy
16
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...
16
Heart Failure II: Pathophysiology
16
Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
16
Aortic Regurgitation II: Clinical Features and Diagnostic Tests
27
Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
27
Mitral Stenosis II: Clinical features and Diagnostic Tests
23
Mitral stenosis is a heart condition in which the mitral valve, which allows blood to flow from the left atrium to the left ventricle, becomes narrowed or stenotic. This narrowing hinders blood flow and leads to clinical symptoms requiring specific medical evaluations and management strategies. The following overview outlines the clinical symptoms, assessments, diagnostic findings, prevention methods, and treatments for mitral stenosis.Clinical ManifestationsDyspnea (shortness of breath): This...
23
Cardiomyopathy II: Dilated Cardiomyopathy
11
Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
11
Pathophysiology of Heart Failure
1.6K
Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
1.6K


