机械失调与隔膜痕结合可靠地识别了对心脏再同步治疗的响应者
Jürgen Duchenne1,2, Camilla K Larsen3,4,5, Marta Cvijic1,2
1Department of Cardiovascular Sciences, KU Leuven, 3000 Leuven, Belgium.
Journal of clinical medicine
|September 28, 2023
概括
结合机械失调和隔膜痕评估,准确预测心脏再同步治疗 (CRT) 响应者和死亡率. 这种成像方法增强了患者对CRT的选择,改善了结果.
科学领域:
- 心脏病学 心脏病学
- 医疗成像医学成像
- 心脏衰竭治疗方法 治疗方法
背景情况:
- 声心成像上的机械失同预测了心脏再同步治疗 (CRT) 后的积极结果.
- 然而,心肌痕可能会降低CRT的有效性.
- 识别CRT响应者对于优化治疗疗效至关重要.
研究的目的:
- 评估机械失调和心肌痕标志物对CRT反应的联合预测能力.
- 将这种综合评估与QRS持续时间和形态等传统预测指标进行比较.
- 评估综合标志物对CRT后长期死亡率的影响.
主要方法:
- 一项前性多中心研究,涉及170名CRT接受者.
- 机械失调标记的心声评估:隔膜闪,顶端摇,缩拉伸指数和侧向隔膜工作差异.
- 通过心脏磁共振成像或通过冠状动脉血管图和临床病史排除心肌痕的量化.
主要成果:
- 机械失调和隔膜痕的综合评估显示,CRT反应具有很高的预测能力 (AUC 0.81-0.86),表现优于单独的机械失调.
- 传统的预测指标 (QRS形态,持续时间,LV喷射率) 并没有优越.
- 综合评估还显著预测了所有原因的死亡率.
结论:
- 对心声回声学机械失调和心肌痕的综合评估是识别CRT响应者的强大工具.
- 视觉和定量成像标记都显示出高可行性和类似的预测结果.
- 这种综合成像方法在常规临床实践中对CRT候选人选择有价值.
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