左心室末缩直径可能预测持续性心力衰竭与减少的射出分数
Takuma Takada1,2, Yuki Nakata1, Katsuhisa Matsuura1,2
1Department of Cardiology, Tokyo Women's Medical University.
International heart journal
|November 15, 2023
概括
持续性心力衰竭与减少喷射分数 (HFrEF) 与较差的结果有关. 左心室末缩直径 (LVESD) 在排出时超过55毫米,预测持续的HFrEF,有助于临床风险分层.
科学领域:
- 心脏病学 心脏病学
- 心声回声扫描 (Echocardiography) 是一种心声回声扫描.
- 心脏衰竭研究研究
背景情况:
- 与改善喷射率 (HFimpEF) 的心力衰竭相比,减少喷射率 (HFrEF) 的持续性心力衰竭与更差的患者预后有关.
- 关于用于识别持续性HFrEF的回声心脏学预测因子的数据有限.
- 心声成像是评估心力衰竭患者心脏结构和功能的关键成像方式.
研究的目的:
- 评估医院出院时回声心脏学参数的预测值,以确定1年随访时持续的HFrEF.
- 确定特定的心声回声标记,可以对HFrEF患者的风险进行分层.
- 为了确定心声回声学发现是否可以帮助临床决策,用于先进的高频管理.
主要方法:
- 对443名最初被诊断为HFrEF (EF ≤40%) 的患者进行了回顾性分析.
- 在出院和1年随访时进行心声扫描,将患者分类为持久的HFrEF或HFimpEF (EF>40%).
- 包括卡普兰-梅尔,接收器操作特征 (ROC) 曲线和多变量后勤回归在内的统计分析被用于评估预测值.
主要成果:
- 在443名患者中,68% (301) 患有持续的HFrEF,32% (142) 患有1年随访后的HFimpEF.
- 左心室末缩直径 (LVESD) 显示了持续性HFrEF的最高预测准确度 (AUC:0.70),切线为55mm.
- 排放时LVESD≥55毫米是持续HFrEF (OR:1.07) 的独立预测因素,与LVESD<55毫米相比,与更高的发病率 (81%对55%) 相关.
结论:
- 在医院出院时,LVESD的55mm或更高与持续的HFrEF在1年的随访中显著相关.
- 测量LVESD是HFrEF患者风险分层的一个有价值的工具.
- 将LVESD评估纳入临床实践可能会改善对标准治疗耐药的高级HF的管理决策.
相关概念视频
01:29Heart 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
01:30Heart Failure IV: Classification and Diagnostic Evaluation
16
Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...
16
01:17Pathophysiology of Heart Failure
1.6K
Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
1.6K
01:20Mitral 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
01:30Cardiomyopathy II: Dilated Cardiomyopathy
11
Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
11