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非扩张左心室心肌病与扩张心肌病:临床背景和结果
Yuko Eda1, Takeru Nabeta1,2, Saeko Iikura1
1Department of Cardiovascular Medicine, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan.
ESC heart failure
|February 6, 2024
概括
没有扩张的左心室心肌病与减少喷射分数 (NDLVC-REF) 显示出与扩张心肌病 (DCM) 相似的心脏事件率. 然而,在诊断后出现左心室扩张的NDLVC-REF患者面临较差的结果,需要密切监测.
科学领域:
- 心脏病学 心脏病学
- 心血管医学 心血管医学
- 心脏衰竭研究研究
背景情况:
- 非扩张左心室肌肉病 (NDLVC) 是一种被提议的心脏肌肉病类别,其特点是保持左心室 (LV) 尺寸,尽管有墙壁运动异常或痕.
- 与传统扩张性心肌病 (DCM) 相比,NDLVC的临床特征和预后影响,特别是减少LV射出分数 (NDLVC-REF),仍然不清楚.
研究的目的:
- 调查诊断为NDLVC和减少LV射出分数 (NDLVC-REF) 的患者的临床特征和心脏事件率.
- 将NDLVC-REF患者与被诊断为扩张性心肌病 (DCM) 的患者进行比较.
主要方法:
- 从2004年12月到2018年1月,对363名新诊断的非缺血性心肌病症和减少LV喷射率 (<50%) 的患者进行了回顾性分析.
- 如果LV维度指数≤31mm/m2 (男性) 或≤34mm/m2 (女性),患者被归类为NDLVC-REF (n=80),否则被归类为DCM.
- 心脏事件包括心脏突然死亡和心力衰竭再住院;随访中位数为68.8个月.
主要成果:
- 与DCM患者相比,NDLVC-REF患者表现出更高的心房动和更高的基线LV喷射率.
- 在整个随访期间,在NDLVC-REF和DCM中,LV喷射分数仍然较高,LV终端透气直径更小.
- 在NDLVC-REF和DCM组之间没有观察到心脏事件发生率的显著差异 (P=0.349).
- 在NDLVC-REF患者 (14%) 中,在诊断后出现LV扩张的小组显示,心脏事件的风险明显更高 (P=0.049).
结论:
- NDLVC-REF和DCM的整体心脏病发病率相似,这表明这些疾病的长期预后相似.
- 在诊断后经历LV扩张的NDLVC-REF患者中,很大一部分 (18%) 的结果不佳.
- 无论是NDLVC-REF还是DCM患者,都需要同等的临床关注,定期跟踪和对LV功能的一致评估.
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