耳前功能性心回的自然历史
Jwan A Naser1, Francisco B Alexandrino1, Tomonari Harada1
1Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Journal of the American College of Cardiology
|March 26, 2024
概括
在患有中度/重度心房功能性 mitrale regurgitation (AFMR) 的患者中,回归比进展更为常见,并且没有影响死亡率. 扩张功能障碍,而不是AFMR变化,预测死亡率,没有增加左心室缩功能障碍 (LVSD) 的风险.
科学领域:
- 心脏病学 心脏病学
- 心血管成像 - 心血管成像
- 心脏生理学 心脏生理学
背景情况:
- 中度/重度心房功能性心肌反 (AFMR) 的自然史在很大程度上是未知的.
- 了解AFMR的进展,回归以及对左心室 (LV) 功能的影响对于患者管理至关重要.
研究的目的:
- 在AFMR患者中调查左心室缩功能障碍 (LVSD) 的发生率.
- 为了确定轻度中度/中度AFMR的进展或回归率.
- 评估AFMR变化和腹筋功能障碍对所有原因死亡率的影响.
主要方法:
- 左心房 (LA) 体积指数≥40mL/m2,≥轻度至中度AFMR的成年人接受了心声回声学随访.
- 记录了LVSD事件,AFMR进展到严重,以及回归到无/微不足道.
- 时间依赖的共变量分析了AFMR变化与死亡率的关系;与对照组相比,LVSD发病率.
主要成果:
- 在平均2.2年的时间里,每100人/年发生率为LVSD的3.2,AFMR进展的1.9,AFMR回归的3.9.
- 女性性别和更大的LA体积指数预测了进展;年轻的年龄,男性性别,没有心房动,和更高的LA排空分数预测了回归.
- 无论是AFMR的进展还是回归都与死亡率无关;年龄较大,同心的LV几何形状和升高的LV填充/肺压是死亡率预测因素.
结论:
- 在患有主要轻度至中度/中度AFMR的患者中,回归比进展更频繁,两者都不会影响死亡率.
- 扩张功能异常,而不是AFMR动态,是死亡率的更重要的预测因素.
- 在中位数为2年的随访期间,没有观察到LVSD的风险增加.
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