通过心声学和MRI评估的严重大动脉狭窄的右心室功能
Erica Holmberg1, Éva Tamás1, Eva Nylander2
1Department of Thoracic and Cardiovascular Surgery, Linköping, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
Clinical physiology and functional imaging
|November 20, 2023
概括
严重的大动脉狭窄症 (AS) 通常会损害右心室 (RV) 功能,影响手术结果. 心声学可以在AS患者显著减少RV射出分数之前检测到微妙的RV变化.
科学领域:
- 心脏病学 心脏病学
- 心脏成像 - - 心脏成像
- 膜心脏疾病 膜心脏疾病
背景情况:
- 大动脉狭窄 (AS) 的患病率正随着人口老龄化而上升.
- 右心室 (RV) 功能会影响外科手术的结果,但在AS中没有得到充分的研究.
- 在严重的AS患者中,常规的RV评估往往缺乏.
研究的目的:
- 为了研究严重AS和RV功能之间的关系.
- 为了比较心血管磁共振成像 (CMR) 和胸腔回声心脏成像 (TTE) 在接受SAVR的严重AS患者的VR评估中.
主要方法:
- 严重AS患者接受了SAVR前的CMR和TTE.
- 通过TTE (TAPSE < 17mm,RVFWS > -20%) 和CMR (RVEF < 50%) 定义的RV功能障碍.
主要成果:
- 三分之一 (33%) 的患者表现出VR功能障碍.
- RV功能障碍与较低的指数化主动脉面积,LV喷射率和中风体积有关.
- 微妙的RV功能变化被TTE检测到,即使通过CMR正常的RVEF.
结论:
- 在接受SAVR的重症AS患者中,三分之一的VR功能障碍是普遍存在的.
- 心声学可以在显著的RVEF下降之前识别早期的RV功能变化.
- 增加AS严重程度可能与VR功能障碍的发病率更高相关.
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