在无症状个体中,左心室缩功能障碍的表型化改善了风险分层
Elisa Rauseo1,2, Musa Abdulkareem1,2,3, Abbas Khan4,5
1William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University London, Charterhouse Square, London EC1M 6BQ, UK.
European heart journal. Cardiovascular Imaging
|September 12, 2023
概括
确定了三组患有左心室缩功能障碍 (LVSD) 的患者群. 这些不同的群体对主要不良心血管事件 (MACE) 存在不同的风险,指导个性化预防策略.
科学领域:
- 心脏病学 心脏病学
- 生物统计学 生物统计学
- 医疗成像医学成像
背景情况:
- 左心室缩功能障碍 (LVSD) 是一种复杂的疾病,预后有很大差异.
- 在无症状个体中确定不同的患者亚组对于制定有针对性的预防策略至关重要.
- 目前的表型化方法可能无法完全捕捉LVSD的异质性.
研究的目的:
- 使用多维数据聚类在无症状个体中探索LVSD的临床表型.
- 调查已识别的LVSD集群与临床结果之间的关联,包括心力衰竭的发展和主要不良心血管事件 (MACE).
- 评估与不同LVSD临床表型相关的心血管异常.
主要方法:
- 集群分析应用于来自1563名英国生物库参与者的60个临床变量,其左心室喷射分数减少 (LVEF<50%),但之前没有心力衰竭.
- 该研究评估了心力衰竭,心血管事件,死亡和MACE在确定集群中的风险.
- 心血管成像特征与聚类变量分开评估.
主要成果:
- 确定了三种不同的LVSD临床集群,显示出生活方式,危险因素,心电图参数和心脏代谢概况的显著差异.
- 从集群1到集群3观察到风险的逐渐增加,独立于传统的风险因素和LVEF.
- 集群3,最高风险组,表现出不良的心血管成像发现,包括更大的LV重塑和心肌功能障碍,与集群1相比,MACE风险显著增加 (1.72倍).
结论:
- 临床数据的多维聚类成功确定了无症状个体中LVSD的三个不同的风险概况和临床轨迹.
- 这些已识别的LVSD亚型为改进表征提供了机会.
- 基于特定LVSD亚型的量身定制干预措施可能会改善临床结果.
相关概念视频
Cardiomyopathy III: Hypertrophic Cardiomyopathy
16
Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
16
Mitral Stenosis II: Clinical features and Diagnostic Tests
22
Mitral stenosis is a heart condition in which the mitral valve, which allows blood to flow from the left atrium to the left ventricle, becomes narrowed or stenotic. This narrowing hinders blood flow and leads to clinical symptoms requiring specific medical evaluations and management strategies. The following overview outlines the clinical symptoms, assessments, diagnostic findings, prevention methods, and treatments for mitral stenosis.Clinical ManifestationsDyspnea (shortness of breath): This...
22
Aortic Regurgitation II: Clinical Features and Diagnostic Tests
23
Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
23
Heart Failure II: Pathophysiology
15
Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
15


