异常区域性心肌功能对于预测心律失常性右室内心肌病的风险的附加值
Feddo P Kirkels1,2,3,4, Christine Rootwelt-Norberg4,5, Laurens P Bosman1
1Division of Heart and Lungs, Department of Cardiology, University Medical Centre Utrecht, Heidelberglaan 100, Utrecht 3582 CX, The Netherlands.
European heart journal. Cardiovascular Imaging
|July 20, 2023
概括
在心律失常的右心室心肌病 (ARVC) 中,心声图区域功能改善了心室心律失常 (VA) 风险预测. 正常的RV变形表明风险低,有助于决定可植入心脏转换器-除器植入.
科学领域:
- 心脏病学 心脏病学
- 医疗成像医学成像
- 预测分析是一种预测分析.
背景情况:
- 节律失调的右心室心肌病变 (ARVC) 构成由于心室节律失调 (VA) 引起的突然心脏死亡的显著风险.
- 现有的ARVC患者的风险计算器预测了第一次持续的VA,但其精度可以提高.
- 心声变形成像提供了详细的心室区域功能评估.
研究的目的:
- 为了评估区域心室功能异常的附加预后价值,通过心声变形成像评估,对已建立的ARVC风险计算器进行评估.
- 为了确定特定的回声心脏学参数是否可以改进ARVC患者首次持续VA的个性化预测.
主要方法:
- 150名没有先前VA的ARVC患者接受了心声回声学变形分析.
- 患者的随访时间中位数为6.3年,首次持续的VA作为主要终点.
- 多变量分析评估了与ARVC风险计算器一起对心声回声学参数的独立预测值.
主要成果:
- 所有测试的左心室和右心室 (LV和RV) 变形参数都是VA的单变预测指标.
- 经过调整后,两种RV变形参数RV自由壁纵向应变和区域RV变形模式仍然是独立的预测因素.
- 这些参数改善了风险计算器的区分值 (C-统计从0.78到0.82).
- 在基线异常区域RV变形模式预测VA在5年内.
结论:
- 区域心声学功能异常显著提高ARVC患者个性化的心律失常风险预测.
- 正常的RV变形具有很高的负预测值,可能指导植入式心脏转换器-除器 (ICD) 定时的决策.
- 这种成像技术为完善ARVC风险分层和临床管理提供了有价值的工具.
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