通过液体负荷评估右心储备功能预测左心室辅助装置植入后的晚期右心衰竭
Masaki Tsuji1, Takahiro Kurihara1, Yoshitaka Isotani1
1Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
The Canadian journal of cardiology
|February 25, 2024
概括
在左心室辅助装置 (LVAD) 植入后评估右心功能至关重要. 在右心导管治疗期间的液体挑战可以预测LVAD患者晚期右心力衰竭 (LRHF).
科学领域:
- 心脏病学 心脏病学
- 心血管外科心血管外科
- 医疗器械 医疗器械
背景情况:
- 左心室辅助器件 (LVAD) 对晚期心力衰竭至关重要.
- 晚期右心力衰竭 (LRHF) 是LVAD后的一个显著并发症.
- 在LVAD植入后评估右心储备功能仍然具有挑战性.
研究的目的:
- 评估右心脏预负载储备功能的使用液体负载测试.
- 调查这项评估对预测LRHF的影响.
主要方法:
- 包括接受连续流动LVAD的18岁以上的患者.
- 在植入术后一个月进行了右心导管治疗,并加盐液 (10毫升/千克).
- 分析了血液动力学参数,包括肺动脉脉动率指数 (PAPi) 和右心室中风工作指数 (RVSWi) 变化率.
主要成果:
- 在149名患者中发生了31例LRHF或死亡.
- 较低的静止PAPi和RVSWi变化比与盐水负载在LRHF组显著不同.
- 这些参数被确定为LRHF和死亡的术后风险.
结论:
- 血液动力学评估与盐水负载有效评估右心室预负载储备功能的LVAD患者.
- 盐水加载后低RVSWi变化比率是LVAD后LRHF的风险因素.
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