在非膜性心肌患者中,对左心房附属体功能与中风风险之间的相关性进行二维斑点跟踪成像分析
Xiwangmin Zheng1, Haitao Ran1, Jianli Ren1
1Department of Ultrasound, The Second Affiliated Hospital of Chongqing Medical University, No.74, Linjiang Road, Yuzhong District, Chongqing, 40010, China.
The international journal of cardiovascular imaging
|December 18, 2023
概括
通过二维斑点跟踪成像 (2D-STI) 测量的左心房附属体 (LAA) 应变和应变率可以预测心房患者中风发生率. 这种新的方法增强了当前针对非膜肌痛 (NVAF) 的风险分层策略.
科学领域:
- 心脏病学 心脏病学
- 医疗成像医学成像
- 预防中风 预防中风
背景情况:
- 脑卒中是心房动 (AF) 的严重并发症,通常与左心房附属体 (LAA) 中的血栓形成有关.
- 目前对非膜肌痛风险 (NVAF) 的风险分层可能无法完全捕捉中风风险.
- 评估LAA功能对于了解AF患者中风风险至关重要.
研究的目的:
- 调查LAA菌株/菌株率与AF患者中风发病率之间的关联.
- 评估LAA菌株和菌株率对NVAF中风风险分层的有用性.
- 开发一种预测模型,将LAA应变/应变率与中风风险相结合.
主要方法:
- 使用二维斑点追踪成像 (2D-STI) 来测量LAA变异和变异速率.
- 分析了333名非膜AF患者的数据,比较了有和没有中风/TIA史的患者.
- 采用多变量后勤回归来识别独立的风险因素并构建预测模型.
主要成果:
- 确定了LAA菌株和菌株率作为NVAF患者中风发病率的独立预测因子,除了非气囊性AF,CHA2DS2VASc得分和LAA血栓/自发回声对比.
- 综合预测模型显示出优异的区分能力 (AUC 0.91) 和良好的校准.
- 该模型与单独的CHA2DS2VASc得分相比,显示出优异的预测性能和重新分类.
结论:
- 通过2D-STI评估的LAA变异和变异率,为LAA功能提供了宝贵的见解.
- 这些心声回声学参数可以提高AF患者中风现有的临床风险评分策略的预测价值.
- 开发的模型为NVAF患者提供了改善的中风风险分层.
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