标准化和验证 neoLVOT 评估使用三维跨食道回声心脏成像在跨导管美特拉更换之前
Soha Hekal1, Amr Y Emam1, Nagwa Thabet1,2
1Adult Cardiology department, Aswan Heart Centre, Magdi Yacoub Foundation, Aswan, Egypt.
Echocardiography (Mount Kisco, N.Y.)
|March 25, 2024
概括
末缩是评估最狭窄的新LVOT区域的最佳心脏阶段,在跨导管中枢置换 (TMVR) 规划期间. 三维跨食道心声学 (3DTEE) 软件可靠地测量这个区域,作为CT的替代品.
科学领域:
- 心血管成像 - 心血管成像
- 医疗器械技术 医疗器械技术
- 干预心脏病学 干预心脏病学
背景情况:
- 透导管关置换 (TMVR) 为高风险手术患者提供了一个替代方案.
- 心脏计算机断层扫描 (CT) 是 TMVR 规划的标准,但对 neoLVOT 评估的最佳心缩阶段仍在争论中.
- 新的3D横食管回声心脏 (3DTEE) 软件为CT提供了潜在的替代方案或过器,特别是对于CT禁用患者.
研究的目的:
- 为了确定系统性阶段与最狭窄的新LVOT区域标准化TMVR规划.
- 为了验证一个新的基于3DTEE的软件与CT对准,用于额头环 (MA) 和neoLVOT测量.
主要方法:
- 对20名患者CT扫描的回顾性分析,以确定neoLVOT测量最佳的缩阶段.
- 使用CT和新的3DTEE软件对49名患者进行标准化末分析.
- 将3DTEE衍生参数与金标准CT测量的比较.
主要成果:
- 末缩显示了最狭窄的新LVOT区域 (224 mm2与早期缩的299 mm2,p=0.005).
- 在MA和NeoLVOT尺寸和面积的3DTEE和CT之间观察到良好的相关性 (r > 0.92).
- 虚拟的大小在CT和3DTEE之间是相同的,在观察者之间和观察者内部有很好的一致性 (ICCs>0.80).
结论:
- 在TMVR规划中,终端缩应该是neoLVOT评估的标准化阶段.
- 基于3DTEE的软件是CT对MA和NeoLVOT评估的可靠替代方案.
- 对于无法接受CT扫描的患者,3DTEE可以作为查工具或替代方案.
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