扩张性心肌力学及其与心室填充压力及其与功能单心室的术后过程的关系
Jeong Jin Yu1, Lars Grosse-Wortmann2,3, Cameron Slorach3
1Division of Pediatric Cardiology, College of Medicine, University of Ulsan, Seoul, South Korea.
Journal of applied physiology (Bethesda, Md. : 1985)
|July 20, 2023
概括
不协调的心室壁运动,而不是标准的透气参数,与Fontan手术后功能单心室 (FSV) 患者的结果有关. 评估这两个心室的运动为患者管理提供了宝贵的见解.
科学领域:
- 心脏病学 心脏病学
- 儿童心脏病学 儿童心脏病学
- 心脏外科手术 心脏外科手术
背景情况:
- 扩张性功能障碍显著影响功能单心室 (FSV) 患者的临床结果.
- 准确评估FSV患者的透缩功能,特别是在Fontan手术后,仍然具有挑战性.
- 心室力学和心室间依赖性在透缩功能和整体血液动力学中起着至关重要的作用.
研究的目的:
- 在FSV患者中调查心室力学,心室间依赖性和舒张参数之间的关联.
- 确定这些心声回声检测结果与Fontan手术后的早期结果之间的关系.
- 确定新的心声回声标记器,以评估透静功能和预测FSV的术后过程.
主要方法:
- 61名FSV患者在同一天接受了心声回声,心脏导管和磁共振成像.
- 分析了心声学参数,包括腹心流量,组织速度,心室质量和不协调的墙壁运动.
- 不协调的墙壁运动是由动力障碍细分或侧壁延迟定义的,在二次心室进行了额外的分析.
主要成果:
- 标准心声回声扫描对静脉压的参数与腹腔末端静脉压 (VEDP),血液动力学或临床结果没有相关性.
- 不协调的墙壁运动是唯一与VEDP,氧和,肺血管阻力和输管持续时间微弱相关的心声回声参数.
- 考虑到非主导 (次要) 室壁的不协调的运动,这些关联得到了加强.
结论:
- 不协调的腹腔壁运动,而不是传统的透气参数,与FSV患者的VEDP和早期术后结果有关.
- 在主导心室和相当大的二次心室中分析异常的壁面运动是必要的,以便在Fontan后进行全面的FSV评估.
- 将不协调的墙壁运动分析纳入常规心声回声评估中,可以改善FSV患者的风险分层和管理.
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