左心室质量,心肌结构和严重大动脉狭窄症中的功能:心声和心磁共振成像研究
Jason Craft1, Jonathan Weber2, Jane J Cao1
1DeMatteis Cardiovascular Institute; Division of Cardiac Imaging, St. Francis Hospital & Heart Center, Roslyn, New York.
The American journal of cardiology
|August 26, 2023
概括
在严重的大动脉狭窄时,左心室质量指数 (LVMI) 升高并没有预测更糟糕的结果. 这项研究发现,较高的LVMI与增加的死亡率或心力衰竭住院治疗之间没有关联.
科学领域:
- 心脏病学 心脏病学
- 心血管成像 - 心血管成像
- 心脏核磁共振成像 (MRI) 的使用.
背景情况:
- 关于严重的大动脉狭窄 (AS) 中左心室缩 (LVH) 的预后值存在相互矛盾的数据.
- 准确的预后分层对于管理严重AS患者至关重要.
研究的目的:
- 用心磁共振成像 (CMR) 和心声谱来描述严重AS的左心室 (LV) 几何和心肌变化.
- 评估 LV 质量指数 (LVMI) 定义的 LV 缩的预后影响,在严重的 AS.
主要方法:
- 对93名严重AS患者的前性评估,同时进行心声学和CMR.
- 评估LVH,心脏结构,形态和晚期加多增强 (LGE).
- 使用卡普兰-梅尔曲线和考克斯比例危险模型进行预测分层.
主要成果:
- 41%的患者患有LVH (LVMI>2 SD高于正常),15%的患者患有严重升高的LVMI (>4 SD).
- 患有LVH的患者表现出较高的LV体积,增加的LGE负担和减少的LV射出分数.
- 在患有LVH的患者中,注意到LV菌株和心房功能受损.
- 升高的LVMI与增加全因死亡率或心力衰竭住院治疗无关.
结论:
- 在严重的AS中,升高的LVMI与不良临床结果没有独立关联.
- 心脏成像发现,如LVH中受损的菌株和LGE,需要进一步调查预后意义.
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