心力衰竭中的双心肌病与保存的喷射分数
Kazunori Omote1, Hidemi Sorimachi1, Masaru Obokata1
1Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA.
European journal of heart failure
|December 7, 2023
概括
心力衰竭中的双心肌病与保存的喷射分数 (HFpEF) 表明疾病更严重,结果更差. 这种情况与心脏功能低下以及住院或死亡风险增加有关.
科学领域:
- 心脏病学 心脏病学
- 心脏衰竭研究研究
- 在心房肌病症.
背景情况:
- 左心房 (LA) 肌病是心力衰竭的已知的特征,具有保存的射出分数 (HFpEF).
- 右心房 (RA) 改造和功能障碍也在HFpEF中发生,但对单独或联合心房肌病的数据有限.
研究的目的:
- 研究HFpEF患者中隔离LA,隔离RA和双心肌病的临床特征和病理生理学.
- 在HFpEF中确定不同心房肌病模式的预后影响.
主要方法:
- 评估了476名HFpEF患者,使用侵入性血液动力学运动测试和综合成像,包括斑点跟踪菌株回声心脏学.
- 根据LA体积指数和/或LA储菌株来定义LA肌病,根据RA体积指数和/或RA储菌株来定义RA肌病.
- 在2.9年的中位数随访期间评估了临床结果.
主要成果:
- 26%的患者没有心房肌病,31%的患者有孤立的LA肌病,39%的患者有双心肌病,4%的患者有孤立的RA肌病.
- 双心肌病与更多的心房动,较差的左心室和右心室功能,严重的肺血管疾病和心脏输出储备的减少有关.
- 与单独的LA肌病相比,患有双心肌病的患者患HF住院或死亡的风险高出84%.
结论:
- 双心肌病症意味着先进的HFpEF与严重的肺血管疾病,右心力衰竭和心脏储备不足.
- 双心肌病与显著增加心血管不良事件的风险有关.
- 需要进一步的研究,以建立最佳的治疗和预防策略,在HFpEF的双心肌病.
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