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左心房附属体流速预测了密码性中风中的隐形心房动:一个Crypton-ICM注册表

Yuji Ueno^1,2, Nobukazu Miyamoto³, Kenichiro Hira³

¹Department of Neurology, Faculty of Medicine, Juntendo University, Tokyo, Japan. yuji-u@juntendo.ac.jp.

Journal of neurology

|August 23, 2023

概括

通过穿食管心声学 (TEE) 测量的左下心房附属体流速 (LAA-FV) 低于37.5厘米/秒,预测密码性中风患者的可插入心脏监视器 (ICM) 检测心房动 (AF).

科学领域:

心脏病学心脏病学
神经学神经学
医疗成像医学成像

背景情况:

密码性中风需要调查血源,如心房动 (AF).
插入式心脏监测器 (ICM) 和透食管心声谱 (TEE) 是关键的诊断工具.
左心房附属体流速 (LAA-FV) 与ICM检测到的AF之间的关系尚不清楚.

研究的目的:

调查通过TEE测量的LAA-FV与ICM检测到密码性中风患者的AF之间的关联.
为了确定最佳的LAA-FV截止值来预测AF.
评估与ICM检测到的AF相关的因素.

主要方法:

一个多中心注册 (克里普顿-ICM) 的密码性中风患者与ICM植入.
在注册患者中使用TEE对LAA-FV的评估.
接收机运行特征 (ROC) 曲线分析以确定LAA-FV切线和Cox比例危险模型用于关联分析.

主要成果:

在307名患者中,有101名患者 (32.9%) 在ICM上检测到AF.
较低的LAA-FV三角形与老年,心力衰竭和高尿素有关.
LAA-FV<37.5厘米/秒预测ICM检测到的AF具有92.2%的特异性.
调整后的分析显示LAA-FV<37.5厘米/秒 (HR 1.987) 和下LAA-FV三位数 (HR 1.753) 预测了ICM检测到的AF.

结论:

在密码性中风中,LAA-FV<37.5cm/s是ICM检测AF的重要预测因子.
测量LAA-FV的TEE可以帮助长期检测AF,补充栓塞源评估.
这一发现增强了TEE在治疗有AF风险的密码性中风患者的诊断效用.

关键词:

心房动是一种心房动.密码性电脑中风是什么意思插入式心脏监测器是可以插入的心脏监测器.左心房附属体的流量速度流量速度通过食道的心声回声仪 (Transesophageal echocardiography) 是一种心声回声仪.

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