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左心室纤维化作为填充压力和晚期心力衰竭中左心房功能的主要决定因素

Giulia Elena Mandoli¹, Matteo Cameli¹, Maria Concetta Pastore¹

¹Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Viale Mario Bracci, 1, 53100 Siena, Italy.

European heart journal. Cardiovascular Imaging

|December 18, 2023

概括

在晚期心力衰竭患者中,左心峰心纵向应变 (PALS) 的降低与充气压升高和心肌纤维化有很强的相关性,作为治疗策略的关键非侵入性指标.

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.
心脏外科手术心脏外科手术

背景情况:

晚期心力衰竭 (AdHF) 涉及左心室 (LV) 功能障碍,纤维化和升高的填充压力,导致左心房 (LA) 问题.
非侵入性地评估这些因素对于患者管理至关重要.

研究的目的:

调查LA峰期心房纵向应变 (PALS) 与LV填充压力和纤维化侵袭性测量之间的关系.
评估PALS作为在接受心脏移植 (HTX) 的AdHF患者中的非侵入性标志物.

主要方法:

在HTX之前,在64名ADHF患者中使用斑点跟踪心声学 (STE) 评估PALS.
获得了侵入性血液动力学数据 (肺毛细血管压 - PCWP) 和LV心肌纤维化 (从活检).

主要成果:

全球PALS显著减少 (9.65±4.5%) 并与PCWP (R = -0.83;P < 0.0001) 和LV纤维化严重程度 (R = -0.78;P < 0.0001) 强烈反向相关.
PALS是PCWP升高 (>18 mmHg) 的强有力的预测指标,AUC为0.955.
在PALS和LV射出分数 (LVEF) 之间没有发现相关性.

结论:

降低PALS是ADHF中高高的LV填充压力和心肌纤维化的一个强有力的指标.
PALS可以作为一种有价值的非侵入性工具,用于对ADHF患者进行分层,以获得最佳的治疗策略.

关键词:

活组织活检纤维化纤维化心脏衰竭是因为心脏衰竭.左心房应变是左心房应变.肺毛细血管形压力压力移植移植移植移植

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