基于回声心脏图的两种方法的比较,用于评估儿科左心室透静功能障碍.
Xue Xiang1, Xu Zhu1, Min Zheng1
1Department of Ultrasound, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China.
Frontiers in pediatrics
|September 21, 2023
概括
与指南建议相比,基于Z值的标准可以在患有心力衰竭 (HF) 和高风险HF的儿童中更早地发现左心室透静功能障碍 (LVDD). 这种方法有助于为儿科心血管健康及时进行治疗干预.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 心声回声扫描 (Echocardiography) 是一种心声回声扫描.
- 心血管成像 - 心血管成像
背景情况:
- 在儿童中,左心室扩张功能 (LVDF) 的评估对于管理心力衰竭 (HF) 至关重要.
- 美国心声学会 (ASE) /欧洲心血管成像学会 (EACVI) 的当前指南为LVDF评估提供了一个框架.
- 为了提高诊断准确度,正在探索替代方法,例如体表面积 (BSA) 转换的Z值截止值.
研究的目的:
- 为了比较LVDF评估在2016年ASE/EACVI指南建议和BSA转换Z值切线之间的一致性.
- 为了评估这些两个标准的诊断性能,在已确诊心力衰竭的儿童和高风险或低风险的儿童中评估心力衰竭.
主要方法:
- 测量了心声学参数,包括额头环形e'速度,侧面E/e'比率,左心房体积指数和峰值三回速度.
- 使用2016年ASE/EACVI指南标准和BSA转换的Z值截止值来评估LVDF.
- 两种标准之间的一致性和差异在患有HF,高风险HF和低风险HF的儿童队列中被分析.
主要成果:
- 在评估LVDF在患有HF (kappa=0.566) 和高风险HF (kappa=0.468) 的儿童的两个标准之间观察到中等的一致性.
- 与指导标准相比,基于Z值的标准在HF (23.5%) 和高风险HF (8.5%) 组中发现左心室扩张功能障碍 (LVDD) 的阳性率较高 (分别为15.6%和3.2%).
- 在LVDD严重程度的分级中也发现了中等的一致性 (kappa=0.522),Z值标准表明更严重的LVDD.
结论:
- 基于BSA转换的基于Z值的标准可能为在儿科HF和高风险HF人群中早期检测LVDD提供更高的灵敏度.
- 这种方法有可能在患有透支功能障碍的儿童中促进早期的治疗干预.
- 进一步的研究可能会完善Z值为基础的标准的应用,用于儿科LVDF评估.
相关概念视频
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