慢性阻塞性肺病对右心室功能和大动脉置换术后重塑的影响
Rinchyenkhand Myagmardorj1, Jan Stassen1, Takeru Nabeta1
1Department of Cardiology, Heart Lung Center, Leiden University Medical Center, the Netherlands.
International journal of cardiology
|October 6, 2023
概括
慢性阻塞性肺病 (COPD) 在动脉置换 (AVR) 后影响右心室 (RV) 功能. 虽然非COPD患者的RV功能恶化,但COPD患者的RV状况有所改善,尽管COPD独立预测死亡率.
科学领域:
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
- 心声回声扫描 (Echocardiography) 是一种心声回声扫描.
背景情况:
- 慢性阻塞性肺病 (COPD) 和右心室 (RV) 功能障碍与前列动脉置换 (AVR) 后的不良结果有关.
- 慢性肺炎对VR功能和AVR后重塑的具体影响尚不清楚.
研究的目的:
- 为了研究AVR接受的COPD和没有COPD的患者的VR功能和重塑.
- 确定COPD对AVR后结果的预后影响.
主要方法:
- 接受手术或通过导管AVR治疗严重大动脉狭窄症 (AS) 的患者被评估COPD.
- 在基线和AVR1年后进行了心声图测量.
- 全因死亡率作为主要研究终点.
主要成果:
- 在275名患者中,有90人 (33%) 患有COPD.
- 非COPD患者在1年后表现出轻微的VR恶化 (缩小缩外流,VR扩张).
- 慢性肺炎患者表现出改善的RV纵向拉伸和壁厚,但RV外流通道扩张.
结论:
- 在非COPD患者中,AVR导致轻微的VR恶化,但在COPD患者中改善了VR功能和增大.
- 慢性慢性肺炎独立预测所有原因死亡率增加两倍以上.
- 慢性肺炎提供了超越VR功能障碍和重塑的增量预后价值.
相关概念视频
Aortic Regurgitation I: Introduction
10
IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
10
Aortic Regurgitation III: Medical Management
24
Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
24
Mitral Regurgitation I: Introduction
15
Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
15
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
Mitral Stenosis I: Introduction
15
Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
15
Heart Failure II: Pathophysiology
14
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...
14


