在已修复的法洛特四重症的成年人中,右心室异步的预后值
Andrea Papa1,2, Clement Nussbaumer3, Eleni Goulouti3
1Center for Congenital Heart Disease, Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland andreapapa1992@gmail.com.
Open heart
|January 19, 2024
概括
右心室失同没有预测费洛修复四重症后成年人的不良事件. 多模式方法有效地确定了高风险患者的不良结果.
科学领域:
- 心脏病学 心脏病学
- 成年人的先天性心脏病
- 心脏成像 - - 心脏成像
背景情况:
- 在手术修复Fallot四重症 (rTOF) 后的残留后果显著影响成年人的长期临床结果.
- 评估右心室 (RV) 功能和同步对于管理这些患者至关重要.
研究的目的:
- 在手术修复后的rTOF几年后,研究VR异步的预后价值在患有rTOF的成人中.
- 在这个人群中确定不良临床事件的预测因子.
主要方法:
- 分析了来自瑞士成人先天性心脏病登记册的队列.
- 使用线下应变分析量化RV和腹腔间异步 (RV Dyssynchrony Index [RVDI]和腹腔间缩短延迟 [IVSD]).
- 多变量考克斯回归确定了复合不良事件 (心律失常,心力衰竭住院,死亡) 的预测因素,并制定了风险得分.
主要成果:
- 在285名患者中,33名 (12%) 在随访期间经历了不良事件.
- 无论是RVDI还是IVSD都与临床事件无关.
- NT-proBNP,右心房区域和心率峰值是不良结果的独立预测因素.
- 风险得分有效分层患者,低风险组的不良事件为0%,高风险组的不良事件为62%.
结论:
- 在患有rTOF的成年人中,RV异步替代品无法预测临床结果.
- 综合NT-proBNP,心房大小和心率的多模式方法被证明对风险分层是有效的.
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