左心室全球纵向菌株作为高性心肌病的预后因子,其低正常的左心室喷射分数
You-Jung Choi1,2, Hyun-Jung Lee2,3, Ji-Suck Park4
1Division of Cardiology, Department of Internal Medicine, Korea University Guro Hospital, Seoul, Republic of Korea.
European heart journal. Cardiovascular Imaging
|July 19, 2023
概括
左心室全球纵向应变 (LV-GLS) 是高性心肌病 (HCM) 患者心血管事件的关键预测因子. 较低的LV-GLS值 (≤10.5%) 表示更高的风险,有助于患者风险分层.
科学领域:
- 心脏病学 心脏病学
- 心血管成像 - 心血管成像
- 生物标志物 生物标志物
背景情况:
- 增高性心肌病变 (HCM) 是一种遗传性心肌疾病.
- 50-60%的左心室喷射分数 (LVEF) 被认为是保存的,但可能掩盖潜在的心肌功能障碍.
- 预后标志物对于保持LVEF的HCM患者的风险分层至关重要.
研究的目的:
- 评估左心室全球纵向应变 (LV-GLS) 的预后意义,在患有高慢性病理和50-60%之间的LVEF的患者中.
- 确定LV-GLS是否可以预测这种特定的HCM亚组中的不良心血管结果.
主要方法:
- 对349名HCM患者进行了回顾性队列研究,LVEF为50-60%.
- 主要结局:心血管死亡的组合,包括突然心脏死亡 (SCD) 和与SCD相当的事件.
- 二次结局:SCD/SCD等效事件,心血管死亡和全因死亡.
- 统计分析包括调整的危险比率和接收器操作特征分析,以确定最佳切断值.
主要成果:
- 绝对LV-GLS与初级复合结果独立相关 (调整HR为0.88,P=0.029).
- 确定了绝对LV-GLS的10.5%的最佳切断值.
- 绝对LV-GLS≤10.5%的患者具有显著更高的初级结局风险 (调整HR2.54,P=0.026).
- 绝对LV-GLS≤10.5%也是独立预测的次要结果.
结论:
- LV-GLS是心血管死亡和SCD/SCD等效事件的独立预测因子,适用于保存LVEF (50-60%) 的HCM患者.
- 测量LV-GLS可以提高这一患者群体的风险分层.
- 这些发现支持LV-GLS在HCM管理的临床决策中使用.
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