在心力衰竭中,右心室相位功能与保存的喷射分数:心脏磁共振特征跟踪和结果
Robert Schönbauer1, Fiona Hana1, Franz Duca1
1Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, 1090 Vienna, Austria.
Journal of clinical medicine
|August 26, 2023
概括
通过心脏磁共振成像评估的右心房功能预测了心力衰竭的结果,患者在鼻节律中保留了喷射分数. 心房动否定了这种预后能力.
科学领域:
- 心脏病学 心脏病学
- 心脏成像 - - 心脏成像
- 心脏衰竭研究研究
背景情况:
- 保存喷射分数 (HFpEF) 的心力衰竭是一个重大的临床挑战.
- 右心房 (RA) 的大小和功能越来越被认为是重要的预后标志物.
- 在HFpEF中RA参数的预后值,按心律分层 (鼻律与心房动),需要进一步阐明.
研究的目的:
- 调查RA大小和功能在HFpEF患者的预后影响.
- 为了区分RA参数的预后意义在患有鼻节律 (SR) 和心房动 (AF) 的患者中.
主要方法:
- 心脏磁共振成像 (CMR) 用于评估索引RA体积和空化分数 (RA-EF).
- 在CMR期间,在SR患者中进行了RA壁的特征跟踪.
- 患者接受了右/左心导管,6分钟步行距离 (6MWD) 和NT-proBNP评估.
- 使用前性随访和考克斯回归模型来评估HF住院和心血管死亡的复合终点.
主要成果:
- 在188名HFpEF患者中 (71%为女性,70±8岁),49%患有持续性AF. 85名患者达到复合终点.
- 在SR患者中,受损的RA储应变率 (HR 0.949),RA储应变率 (HR 0.991),RA导管应变率 (HR 0.932) 和RA导管应变率 (HR 0.989) 与更糟糕的结局有显著联系.
- 在持久性AF中,在多变量分析后,没有RA成像参数显示出预后意义.
结论:
- 通过CMR评估的RA导管和储功能受损,是SR患者HFpEF不良心血管结果的显著预测因素.
- 在患有持续性AF的HFpEF患者中,RA参数失去其预后价值.
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