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在心血管磁共振成像和稳定的心脏移植接受者中长期结果上的右心室功能

Collin M Barrett¹, Parag Bawaskar¹, Andrew Hughes¹

¹Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis.

Circulation. Cardiovascular imaging

|April 2, 2024

概括

心脏移植后通过心血管磁共振成像 (CMR) 测量的右心室全球纵向应变 (RVGLS) 预测了长期的不良结果. 这一发现为心脏移植接受者管理和改善他们的预后提供了宝贵的见解.

科学领域:

心脏病学心脏病学
移植医学移植医学
心血管成像 - 心血管成像

背景情况:

右心室 (RV) 功能障碍是心脏移植接受者的已知并发症.
在稳定的心脏移植患者中,RV功能障碍的长期预后影响仍然不清楚.
这项研究调查了通过心血管磁共振成像 (CMR) 移植后发现的RV功能障碍的意义.

研究的目的:

确定心脏移植后至少一年的CMR检测到的RV功能障碍的长期预后值.
评估RV功能障碍与心脏移植接受者的不良临床结果之间的关联.
评估RV喷射率和RV全球纵向应变 (RVGLS) 作为预测结果的指标.

主要方法:

一组257名心脏移植接受者接受了CMR监测.
使用CMR评估了RV喷射分数和RVGLS.
使用多变量考克斯回归分析了VR功能障碍与死亡或主要心脏不良事件的复合终点之间的关联.

主要成果:

RV喷射分数与不良结果没有显著关联.
全球纵向RV菌株 (RVGLS) 独立地与死亡或主要心脏不良事件的风险增加有关 (HR1.08每1%恶化;P=0.046).
RVGLS提供了增量预后值,即使在具有正常RV喷射分数或晚期加多增强的子组中.

结论:

心血管磁共振成像 (CMR) 功能追踪衍生RVGLS,在心脏移植后至少一年评估,是长期不良事件的独立预测器.
RVGLS可能在风险分层和指导心脏移植接受者的临床决策方面发挥关键作用.
需要进一步的研究来探索RVGLS在治疗心脏移植患者中的临床实用性.

关键词:

在临床决策过程中.全球纵向菌株全球纵向菌株心脏移植心脏移植手术磁共振成像技术的使用心肌梗塞的心脏病发作预后预后预后

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