在初级心肌回中进行心脏逆向重塑:心肌替换与心肌修复
Thomas P Craven1, Pei G Chew1, Laura E Dobson2
1Multidisciplinary Cardiovascular Research Centre & Department of Biomedical Imaging Science, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, LS2 9JT, UK.
概括
在六个月的时间里,伴随着带状脉的保存而进行的中枢置换 (MVR) 显示出与中枢修复 (MVr) 相似的反向重塑和功能益处,在初级中枢反 (MR) 患者中. 需要进一步的研究来证实这些发现用于外科实践.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 心血管成像 - 心血管成像
背景情况:
- 在指导方针中,偏好对膜修复 (MVr),而不是对膜更换 (MVR),以治疗初级膜吐 (MR).
- 跨胸腔心声学 (TTE) 已被用于评估反向重塑.
- 心血管磁共振 (CMR) 提供卓越的双心室评估和MR量化.
研究的目的:
- 为了研究心脏逆向重塑和残留MR.
- 使用序列CMR,比较MVR与MVR的结果,其中MVR与弦保存.
主要方法:
- 83名中度至重度MR患者在基线和6个月后接受了6分钟步行测试 (6MWT) 和CMR.
- CMR包括 cine,相对比,T1地图和晚期加多增强 (LGE) 成像.
- 患者被分组为MVr,MVR与带保存,或警等待 (控制).
主要成果:
- 在6个月后,MVR和MVR组在6MWT和左心室末端透气和左心房体积的减少方面表现出可比的改善.
- 与MVR (21%) 相比,MVR导致了较低的残留MR-regurgitant分数 (12%).
- 与6个月后的MVR相比,右心室喷射分数在MVR后较差.
结论:
- 带有带保护的MVR可能会在初级MR的6个月内提供与MVR相比的可比心脏逆向重塑和功能益处.
- 需要进行更大规模的多中心CMR研究来证实这些发现.
- 结果可能会影响未来的初级MR手术实践.
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