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在患有低梯度严重大动脉狭窄症的患者中,跨膜流速的预后值:一项多布他胺应激心声学研究

Hirokazu Onishi^1,2, Masaki Izumo¹, Haruka Nishikawa¹

¹Department of Cardiology, St. Marianna University School of Medicine, Kanagawa, Japan.

Echocardiography (Mount Kisco, N.Y.)

|November 8, 2023

概括

在多布他胺应激回声心电图 (DSE) 期间的流量率有助于在患有低梯度严重大动脉狭窄症 (LG-SAS) 的患者中分层风险. 低的休息和应力流速 (Qrest和Qstress<200mL/s) 显著预测了糟糕的结果.

科学领域:

心脏病学心脏病学
心声回声图 (Echocardiography) 是一种心声回声图.
膜心脏疾病膜心脏疾病

背景情况:

关于在多布胺应力回声心电图 (DSE) 期间休息时 (Qrest) 和峰值应力 (Qstress) 的跨膜流速 (Qmean) 的临床相关性数据有限.
这对于患有低梯度重度大动脉狭窄症 (LG-SAS) 的患者尤其如此,这种疾病是由低大动脉面积指数 (<0.6 cm2/m2) 和平均压力梯度 (<40 mm Hg) 定义的.

研究的目的:

为了研究Qrest和Qstress在LG-SAS患者的预后价值.
评估这些流量与不良临床结果的关联,包括全因死亡和心力衰竭住院治疗.

主要方法:

对100名被诊断患有LG-SAS的患者的临床数据的回顾性分析,这些患者接受了DSE.
由大动脉面积指数 < 0.6 cm2/m2 和大动脉平均压差 < 40 mm Hg 定义的 LG-SAS.
主要终点:全因死亡和心力衰竭住院治疗. 多变量分析对LVEF,AVPG,CKD,NYHA类和AV替代进行了调整.

主要成果:

主要终点发生在51名患者中,随访时间中位数为2.84年.
多变量分析显示,Qrest < 200 mL/s和Qstress ≥ 200 mL/s (HR 3.844,p=0.030) 与不利的结果有关.
与Qrest和Qstress≥200mL/s相比,Qrest<200mL/s和Qstress<200mL/s (HR9.444,p=0.001) 的相关性更强.

结论:

流动条件,特别是静止和应力跨膜流速的组合,对于LG-SAS患者的风险分层有价值.
识别休息和压力下流量较低的患者可以帮助预测不良结果,并指导临床管理决策.

关键词:

大动脉狭窄症 (大动脉狭窄症)多布他胺压力回声心脏图谱 (echocardiography) 是一种压力回声心脏图谱.低梯度严重的大动脉狭窄症冲击量指数冲击量指数冲击量指数跨膜的流量是什么意思

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