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在连续流动左心室辅助器件中,右心室衰竭和心声预测器的比例:系统性审查和元分析

Maria Benedetto¹, Giulia Piccone¹, Ludovica Nardozi¹

¹Anaesthesiology and Intensive Care, Cardiothoracic and Vascular Department, IRCSS Azienda Ospedaliero-Universitaria Di Bologna, Via Albertoni 15, Bologna, Italy.

Indian journal of thoracic and cardiovascular surgery

|August 1, 2023

概括

连续流动左心室辅助装置 (CF-LVAD) 植入后的右心室衰竭 (RVF) 在28.25%的患者中发生. 像TAPSE,FAC和RVGLS这样的心声学参数可以预测RVF风险.

科学领域:

心脏病学心脏病学
心血管外科心血管外科
医疗成像医学成像

背景情况:

右心室衰竭 (RVF) 是连续流动左心室辅助装置 (CF-LVAD) 植入后的一种严重并发症,与死亡率的增加有关.
确定RVF的手术前预测因子对于改善患者的治疗结果至关重要.

研究的目的:

确定CF-LVAD患者中RVF的总比重.
确定最能与RVF发展相关的术前心声学参数.

主要方法:

2008年至2019年间发表的观察性研究的系统审查和元分析.
在多个电子数据库进行的研究,包括MEDLINE,EMBASE,PubMed和Cochrane图书馆.
PRISMA流程图方法用于确保19项相关研究的系统选择.

主要成果:

在1741名患者的综合人群中,RVF的总比重为28.25% (95%CI:0.24-0.34).
在RVF和非RVF组之间观察到三环状平面缩外流 (TAPSE),部分面积变化 (FAC) 和右心室全球纵向应变 (RVGLS) 的显著变化.
标准化平均偏差表明TAPSE (SMD: -0.33),FAC (SMD: -0.34) 和RVGLS (SMD: 0.52) 与RVF之间的相关性.

结论:

术前心声学参数,特别是TAPSE,FAC和RVGLS,在CF-LVAD植入后显示与RVF相关的趋势.
虽然预测因素仍然不确定,但这些心声回声测量为风险分层提供了潜在的见解.
需要进一步的研究,以充分阐明这些参数在预测CF-LVAD后RVF中的作用.

关键词:

晚期心力衰竭是什么意思晚期心力衰竭连续流动的LVAD可以使用.对心声回声学评估进行评估.右心室衰竭是什么意思

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