脑电图左心室缩在大动脉狭窄:与心脏结构,侵入性血液动力学和长期死亡率的关系
Patrizia Sager1,2, Andreas Rusch1,3, Lukas Weber1
1Department of Cardiology, Kantonsspital St. Gallen, St. Gallen, Switzerland.
Clinical cardiology
|September 23, 2023
概括
佩格罗-洛普雷斯蒂得分有效预测严重的大动脉狭窄患者的左心室缩和心脏损伤. 这种基于心电图的得分也表明了大动脉置换后的长期死亡风险.
科学领域:
- 心脏病学 心脏病学
- 医学诊断 医学诊断 医学诊断
- 心脏外科手术 心脏外科手术
背景情况:
- 左心室缩 (LVH) 是对大动脉狭窄 (AS) 中压力过载的反应.
- 与AS相关的心脏损伤可能跟随LVH,影响患者的预后.
- 电心电图 (ECG) LVH可以预测心脏损伤和大动脉置换 (AVR) 后的结果.
研究的目的:
- 为了评估ECG衍生的LVH是否预测AS患者的回声心脏学LVH.
- 为了确定心电图衍生的LVH是否预测心脏损伤的其他标志物.
- 评估ECG LVH对AVR后死亡率的预后价值.
主要方法:
- 研究了279名严重AS患者,在AVR之前接受了心电图,心声图和心脏导管.
- 评估了索科洛-里昂指数,康奈尔产品,罗姆希尔特-埃斯特斯得分和佩格罗-洛普雷斯蒂得分.
- 分析了与心声图 LVH,侵入性心脏损伤标志物和AVR后全因死亡率的相关性.
主要成果:
- 佩格罗-洛普雷斯蒂得分显示了预测心声 LVH 的最高 AUC.
- 这一分数也最好地预测了心脏损伤的侵入性测量,包括增加的填充压力和肺抵抗力.
- 佩格罗-洛普雷斯蒂得分与AVR后所有原因的死亡率有显著的相关性.
结论:
- 佩格罗-洛普雷斯蒂评分是评估严重AS心脏异常的宝贵工具.
- 它与LVH相关,侵入性心脏损伤标志物,并预测AVR后的长期死亡率.
- 使用Peguero-Lo Presti评分进行心电图评估可以帮助AS患者的风险分层.
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