左心室缩功能参数与心肌损伤,器官衰竭和败血症患者死亡率之间的关联
Patrik Johansson Blixt1, Maxime Nguyen2, Bernard Cholley3,4
1Department of Anaesthesiology and Intensive Care, Biomedical and Clinical Sciences, Linköping University, S-58185, Linköping, Sweden.
Annals of intensive care
|January 18, 2024
概括
新的回声心脏学参数 - - 中心环状平面缩外流 (MAPSE) 和LV纵向壁分数缩短 (LV-LWFS) - - 在败血性休克患者中更好地表明心肌损伤,而不是喷射分数. 它们与临床结果的关联需要进一步调查.
科学领域:
- 心脏病学 心脏病学
- 关键护理医学 关键护理医学
- 心声回声图 (Echocardiography) 是一种心声回声图.
背景情况:
- 左心室喷射分数 (LVEF) 与败血症患者的不良结果存在不一致的关联.
- 新的回声心脏学参数,如 LV 纵向应变 (LVLS),心肌环状平面缩 (MAPSE) 和 LV 纵向壁部分缩短 (LV-LWFS),可能提供更敏感的 LV 功能障碍检测.
- 这些较新的参数在败血症休克的背景下没有得到充分的研究.
研究的目的:
- 评估五个心声回声学参数之间的协会 LV 缩功能和结局在ICU 患有败血性休克的患者.
- 为了比较传统 (LVEF,s ́) 与新 (LVLS,MAPSE,LV-LWFS) 的心声回声学参数的诊断和预后值.
主要方法:
- 152名患有败血性休克的ICU患者在入院后24小时内接受过胸腔心声扫描.
- 主要结局:心肌损伤 (高灵敏度的热素T ≥45 ng/L).
- 二次结果:无器官支持日 (OSFD) 和30天死亡率. 使用多变量分析来评估预后价值.
主要成果:
- 在患有心肌损伤和没有心肌损伤的患者之间,LVLS,MAPSE和LV-LWFS有所不同;LVEF和s ́没有.
- 在多变量调整后,MAPSE和LV-LWFS独立地与心肌损伤有关.
- 没有测试的缩功能参数与OSFD或30天死亡率显著相关.
结论:
- MAPSE和LV-LWFS独立地与败血性休克中的心肌损伤有关,表现优于LVEF,s ́和LVLS.
- 这些新参数与器官支持需求和短期死亡率等临床结果的关联仍然不确定.
- 临床试验的注册:NCT01747187和NCT04695119.9. 临床试验的注册:NCT01747187和NCT04695119. 临床试验的注册:NCT047187和NCT04695119. 临床试验的注册:NCT047187和NCT04695119. 临床试验的注册:
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