在患有严重大动脉狭窄症的患者中,左心室分散和变形的附加预后值
Nicolas Thellier1, Alexandre Altes1, Michael Rietz1
1Lille Catholic Hospitals, Heart Valve Center, Cardiology Department, ETHICS EA 7446, Lille Catholic University, Lille, France.
JACC. Cardiovascular imaging
|November 9, 2023
概括
左心室机械分散 (LV-MD) 独立预测严重大动脉狭窄症 (SAS) 患者的死亡率. 将LV-MD与LV-全球纵向菌株 (LV-GLS) 结合起来,进一步改善了这些患者的风险分层.
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.
- 心脏机械学 心脏机械学
背景情况:
- 斑点跟踪应变回声心脏学量化了左心室机械分散 (LV-MD).
- 在严重的大动脉狭窄 (SAS) 中,LV-MD和LV-全球纵向菌株 (LV-GLS) 的预后值需要澄清.
- 评估LV-MD和LV-GLS可能会改进SAS的死亡风险分层.
研究的目的:
- 调查LV-MD是否与SAS患者的死亡风险增加有关.
- 为了确定LV-MD是否提供了LV-GLS之外的额外预后信息.
- 评估 LV 机械失调会增加死亡风险的假设.
主要方法:
- 招募了364名SAS患者,他们保留了喷射分数和最小的症状.
- 主要终点是全因死亡率.
- 评估LV-MD和LV-GLS使用斑点跟踪心声学.
主要成果:
- LV-MD ≥68 ms与死亡率增加独立相关 (aHR: 1.41).
- 将LV-MD纳入LV-GLS模型显著改善了死亡率预测.
- 患有高LV-MD和低LV-GLS的患者的死亡风险明显较高 (aHR:2.02).
结论:
- LV-MD是一个可重现的参数,独立地与SAS中较高的死亡率有关.
- 对LV-MD和LV-GLS的综合评估确定了高风险SAS患者.
- 需要进一步的研究来确定早期的大动脉置换是否有利于这一亚组.
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